| Alcohol and /or Drug Screening, Testing, Treatment |
4588 |
15 min |
$40.10 |
$47.85 |
N/A |
| Developmental Test Administration |
4589 |
15 min |
$29.59 |
$35.32 |
N/A |
| Psychotherapy (Individual and Family) |
4590 |
15 min |
$33.91 |
$40.46 |
N/A |
| Psychotherapy Group |
4591 |
15 min |
$11.75 |
$13.05 |
N/A |
| Neuropsychological Testing/Evaluation Services |
4592 |
15 min |
$32.89 |
$39.25 |
N/A |
| Psychiatric Diagnostic Examination |
4593 |
15 min |
$49.33 |
$58.86 |
N/A |
| Office Visit |
4594 |
15 min |
$48.74 |
$63.67 |
N/A |
| Smoking Cessation treatment |
4595 |
15 min |
$18.13 |
$21.62 |
N/A |
| ECG |
4596 |
Per occurrence |
N/A |
N/A |
$15.15 |
| Screening - Developmental/Emotional/Behavioral |
4597 |
Per occurrence |
$59.67 |
$71.21 |
N/A |
| Hearing and Evaluation of Speech |
4598 |
15 min |
N/A |
N/A |
$8.37 |
| Immunization (Administration) |
4599 |
Per occurrence |
N/A |
N/A |
$18.03 |
| Lab: Lithium |
4600 |
Per Laboratory Procedure |
N/A |
N/A |
$8.08 |
| Lab: Urinalysis, by dip stick or tablet reagent Lab: Urinalysis, by dip stick or tablet reagent Lab: Urinalysis; Bacterium scree, except B |
4671 |
Per Laboratory Procedure |
N/A |
N/A |
$2.02 |
| Infectious agent antigen detection by immunoassay technique (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID19]) |
4672 |
Per Laboratory Procedure |
N/A |
N/A |
$45.68 |
| Interpreter Services |
4673 |
Per occurrence |
N/A |
N/A |
$11.11 |
| Lab: Urine pregnancy test, by visual color comparison methods |
4674 |
Per Laboratory Procedure |
N/A |
N/A |
$2.02 |
| Lab: Hemoglobin; glycosylated (A1C) |
4675 |
Per Laboratory Procedure |
N/A |
N/A |
$11.11 |
| Blood count; Hemoglobin (HGB) |
4676 |
Per Laboratory Procedure |
N/A |
N/A |
$2.02 |
| Lab: Antibody; HIV-1 |
4677 |
Per Laboratory Procedure |
N/A |
N/A |
$11.11 |
| Lab: Smear, primary source with Interpretation |
4678 |
Per Laboratory Procedure |
N/A |
N/A |
$4.04 |
| Lab: Infectious agent detection by nucleic ac |
4679 |
Per Laboratory Procedure |
N/A |
N/A |
$97.97 |
| Lab: Infectious agent detection by immunoassay |
4680 |
Per Laboratory Procedure |
N/A |
N/A |
$4.04 |
| Lab: Infectious agent antigen detection by IM (Influenza rapid test) |
4681 |
Per Laboratory Procedure |
N/A |
N/A |
$15.15 |
| Lab: Molecular PCR Test |
4682 |
Per Laboratory Procedure |
N/A |
N/A |
$51.82 |
| COVID-19 Specimen Collection (can be reimbursed if specimen collection is a standalone service not associated with an office visit or a COVID-19 Molecular PCR test). |
4683 |
Per Laboratory Procedure |
N/A |
N/A |
$23.69 |
| Tuberculosis (TB) tests |
4684 |
Per Laboratory Procedure |
N/A |
N/A |
$5.05 |
| Medical Nutritional Therapy Service |
4685 |
15 min |
$26.36 |
$31.52 |
|
| Child and Family Treatment and Support Services |
Refer to the Children's HCBS Billing Guidance webpage. |
| Home and Community Based Services |
Refer to the Children's HCBS Billing Guidance webpage. |
