Independent Practitioner Services for Individuals with Developmental Disabilities (IPSIDD) Fees

Independent Practioner Services for Individuals with Developmental Disabilities (IPSIDD) Fees

Fees Effective 4/1/2026

Procedure Codes Authorized Provider Types IPSIDD Max Units Regional Fees*
Procedure Code Note Below CPT Descprition Locality 1 Locality 2 Locality 3 Locality 4 Locality 99
90791   Psy dx evaluation LP (0580)/ LCSW (0560) 1 $191.29 $193.70 $181.36 $194.12 $172.94
90832   Psytx, 30 min LP (0580)/ LCSW (0560) 1 $114.72 $116.10 $108.84 $116.37 $104.00
90834   Psytx, 45 min LP (0580)/ LCSW (0560) 1 $152.93 $154.58 $145.20 $154.98 $139.05
90837   Psytx, 60 min LP (0580)/ LCSW (0560) 1 $211.87 $214.39 $201.07 $214.94 $192.22
90846   Family psytx w/o patient LP (0580) / LCSW (0560) 1 $114.70 $115.95 $108.89 $116.24 $104.23
90847   Family psytx w/patient LP (0580) / LCSW (0560) 1 $229.46 $232.42 $217.64 $232.97 $207.63
90853   Group psychotherapy LP (0580) / LCSW (0560) 1 $59.31 $60.07 $56.22 $60.19 $53.60
92507   Speech/hearing therapy SLP (0623) 1 $123.10 $125.42 $115.68 $125.30 $107.89
92508   Speech/hearing therapy SLP (0623) 1 $35.98 $36.74 $33.70 $36.66 $31.18
92521   Eval of Speech Fluency SLP (0623) 1 $167.32 $170.84 $157.07 $170.63 $145.93
92522   Eval of Speech Sound Production SLP (0623) 1 $167.32 $170.83 $157.08 $170.61 $145.94
92523   Eval of Speech Sound Production with eval of language comprehension and expression SLP (0623) 1 $167.37 $171.26 $156.93 $171.02 $145.19
92524   Behavioral and qualitative analysis of voice and resonance SLP (0623) 1 $167.32 $171.93 $156.72 $171.68 $144.13
92526   Oral function therapy SLP (0623) 1 $123.19 $125.59 $115.63 $125.42 $107.57
92606   Use of non-speech device SLP (0623) 1 $123.39 $125.99 $115.52 $125.71 $106.76
92609   Use of speech device service SLP (0623) 1 $123.39 $125.99 $115.52 $125.71 $106.76
92610   Evaluate swallowing function SLP (0623) 1 $123.22 $125.86 $115.54 $125.67 $107.07
96112 (C) Devel tst phys/qhp 1st hr LP (0580) / LCSW (0560) 1 $153.41 $156.30 $144.70 $156.39 $135.94
96113 (C) Devel tst phys/qhp ea addl LP (0580) / LCSW (0560) 1 $76.71 $78.16 $72.35 $78.21 $67.98
96130 (C) Psycl tst eval phys/qhp 1st LP (0580) / LCSW (0560) 1 $76.51 $77.41 $72.57 $77.60 $69.33
96136 (C) Psycl/nrpsyc tst phy/qhp 1st LP (0580) / LCSW (0560) 1 $152.99 $154.80 $145.12 $155.17 $138.64
96137 (C) Psycl/nrpsyc tst phy/qhp ea LP (0580) / LCSW (0560) 1 $76.51 $77.41 $72.57 $77.60 $69.33
96138 (C) Psycl/nrpsyc tech 1st LP (0580) / LCSW (0560) 1 $154.97 $159.66 $143.77 $158.85 $129.47
96139 (C) Psycl/nrpsyc tst tech ea LP (0580) / LCSW (0560) 1 $77.49 $79.84 $71.90 $79.43 $64.75
97110   Therapeutic exercises, 15 min OT (0621) / PT (0622) 3 $44.71 $45.77 $41.83 $45.67 $39.84
97112   Neuromuscular reeducation, 15 min OT (0621) / PT (0622) 3 $44.95 $45.86 $42.10 $45.77 $39.13
97113   Aquatic therapy/exercises, 15 min OT (0621) / PT (0622) 3 $45.11 $46.20 $42.05 $46.03 $38.44
97116   Gait training therapy, 15 min OT (0621) / PT (0622) 3 $44.97 $45.88 $42.15 $45.79 $39.05
97124   Massage therapy, 15 min OT (0621) / PT (0622) 3 $45.01 $46.21 $42.04 $46.08 $38.49
97129 (B) Ther ivntj 1st 15 min OT (0621) / PT (0622) / SLP (0623) 1 $44.88 $45.65 $42.21 $45.60 $39.48
97130 (B) Ther ivntj ea addl 15 min OT (0621) / PT (0622) / SLP (0623) 2 $44.88 $45.65 $42.21 $45.60 $39.48
97140   Manual therapy, 15 min OT (0621) / PT (0622) 3 $44.97 $45.84 $42.16 $45.74 $39.12
97150   Group therapeutic procedures OT (0621) / PT (0622) 1 $44.88 $45.74 $42.17 $45.71 $39.33
97161 (A) Pt evaluation, low complexity PT (0622) 1 $100.94 $102.95 $94.79 $102.83 $88.21
97162 (A) Pt evaluation, med complexity PT (0622) 1 $134.60 $137.26 $126.39 $137.10 $117.62
97163 (A) Pt evaluation, high complexity PT (0622) 1 $168.25 $171.57 $157.98 $171.38 $147.02
97164 (A) PT re-evaluation, re-defined PT (0622) 1 $101.09 $103.26 $94.69 $103.07 $87.60
97165 (A) Ot evaluation, low complexity OT (0621) 1 $91.01 $93.12 $85.19 $92.92 $78.57
97166 (A) Ot evaluation, med complexity OT (0621) 1 $121.35 $124.16 $113.58 $123.89 $104.75
97167 (A) Ot evaluation, high complexity OT (0621) 1 $151.68 $155.18 $141.97 $154.86 $130.94
97168 (A) OT re-evaluation, re-defined OT (0621) 1 $91.20 $93.43 $85.11 $93.12 $77.94
97530   Therapeutic activities, 15 min OT (0621) / PT (0622) 3 $45.03 $46.00 $42.12 $45.86 $38.83
97533   Sensory integration, 15 min OT (0621) / PT (0622) / SLP (0623) 3 $44.94 $45.77 $42.17 $45.71 $39.25
97535   Self care mngment training, 15 min OT (0621) / PT (0622) 3 $45.01 $45.96 $42.12 $45.85 $38.89
97537   Community/work reintegration, 15 min OT (0621) / PT (0622) 3 $45.77 $46.63 $42.96 $46.56 $35.92
97542   Wheelchair mngment training, 15 min OT (0621) / PT (0622) 8 $48.46 $49.39 $45.47 $49.31 $42.27
97755   Assistive technology assess, 15 min OT (0621) / PT (0622) 6 $44.86 $45.67 $42.19 $45.65 $39.46
* Locality Breakdown
Locality 1 - Manhattan
Locality 2 - Bronx, Brooklyn, Nassau, Rockland, Staten Island, Suffolk, Westchester
Locality 3 - Columbia, Delaware, Dutchess, Greene, Orange, Putnam, Sullivan, Ulster
Locality 4 - Queens
Locality 99 - Remainder of State

Authorized Provider Types
OT Occupational Therapist (PCOS: 0621)
PT Physical Therapist (PCOS: 0622)
SLP Speech and Lang Pathologist (PCOS: 0623)
LP Licensed Psychologist (PCOS: 0580)
LCSW Licensed Clinical Social Worker (PCOS: 0560)

(A) Effective 1/1/2017, the American Medical Association (AMA) replaced procedure codes 97001, 97002, 97003, 97004 with eight new procedure codes.
  • New codes: 97161 through 97168

(B) Effective 1/1/2018, the American Medical Association (AMA) replaced procedure code 97532 with 97127.
  • Effective 1/1/2020, the American Medical Association (AMA) replaced procedure code 97127 with 97129 and 97130.

(C) Effective 1/1/2019, the American Medical Association (AMA) replaced procedure codes as follows:
  • 96101 replaced with 96130, 96131, 96136 and 96137, however, 96131 is not reimbursable by Medicaid.
  • 96102 replaced with 96138 & 96139.
  • 96111 replaced with 96112 & 96113.