Alternative Payment Fee Schedule For Hospital OP
- Fee Schedule is also available in Excel Format (XSL) and Portable Document Format (PDF)
Revised for 1/1/2024 Updates:
| Rate Code | Rate Code Description | Rate | Rate End Date | ||||
|---|---|---|---|---|---|---|---|
| 9/1/2009 | 10/1/2009 | 4/1/2022 | 3/1/2023 | 4/1/2023 | |||
| 1226 | Fitting Of Spectacles; Monofocal; Bifocal; Multifocal | $47.06 | $47.06 | N/A | N/A | N/A | 1/1/2011(1) |
| 1227 | Fitting of spectacles plus eyeglass material - DOWNSTATE | $104.40 | $104.40 | N/A | N/A | N/A | 1/1/2011(1) |
| 1227 | Fitting of spectacles plus eyeglass material - UPSTATE | $134.41 | $134.41 | N/A | N/A | N/A | 1/1/2011(1) |
| 1228 | Comprehensive wheelchair evaluation and management | $302.00 | $305.02 | $305.02 | $324.85 | ||
| 3257 | SBHC-LCSW/LMSW Services 20-30 minutes with patient(2) | $41.00 | $41.00 | $41.41 | $41.41 | $44.10 | |
| 3258 | SBHC-LCSW/LMSW Services 45-50 minutes with patient(2) | $62.00 | $62.00 | $62.62 | $62.62 | $66.69 | |
| 3259 | SBHC-Family Svcs LCSW/LMSW with/without patient (2) | $70.00 | $70.00 | $70.70 | $70.70 | $75.30 | |
| 3260 | SBHC-Individ LMHC/LMFT Service 20-30 min w/patient | $41.41 | $44.10 | ||||
| 3261 | SBHC-Individ LMHC/LMFT Service 45-50 min w/patient | $62.62 | $66.69 | ||||
| 3262 | SBHC-Fam Srvcs LMHC/LMFT with or w/o p/t present | $70.70 | $75.30 | ||||
| 4222 | Individ LMHC/LMFT Services 20-30 min w/patient | $41.41 | $44.10 | ||||
| 4223 | Individ LMHC/LMFT Services 45-50 min w/patient | $62.62 | $66.69 | ||||
| 4224 | Family Srvcs LMHC/LMFT with or w/o p/t present | $70.70 | $75.30 | ||||
| 4257 | LCSW/LMSW Services 20-30 minutes with patient(2) | $41.00 | $41.00 | $41.41 | $41.41 | $44.10 | |
| 4258 | LCSW/LMSW Services 45-50 minutes with patient(2) | $62.00 | $62.00 | $62.62 | $62.62 | $66.69 | |
| 4259 | Family Svcs LCSW/LMSW with/without patient (2) | $70.00 | $70.00 | $70.70 | $70.70 | $75.30 | |
Note: (1) Rate Codes 1226 and 1227 are now paid thru APGs.
(2) This service had been limited to under age 21 and pregnant women, however, the restrcition was removed effective 1/1/2024.
