Alternative Payment Fee Schedule For Hospital

Revised January 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 - Individ Brief Psychotherapy 20-30 min with patient (2) $41.00 $41.00 $41.41 $41.41 $44.10  
3258 SBHC - Individ Compr Psychotherapy 45-50 min with patient (2) $62.00 $62.00 $62.62 $62.62 $66.69  
3259 SBHC - Family Psychotherapy with or w/o patient present (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 Individ Brief Psychotherapy 20-30 min with patient (2) $41.00 $41.00 $41.41 $41.41 $44.10  
4258 Individ Compr Psychotherapy 45-50 min with patient (2) $62.00 $62.00 $62.62 $62.62 $66.69  
4259 Family Psychotherapy with or w/o patient present (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.