|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
7298966
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$35.85 |
| Rate for Payer: Cash Price |
$22.64
|
| Rate for Payer: Cigna Commercial |
$32.08
|
| Rate for Payer: First Health Commercial |
$33.97
|
| Rate for Payer: First Health Workers Compensation |
$14.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$33.97
|
| Rate for Payer: GEHA Commercial |
$26.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$33.97
|
| Rate for Payer: Multiplan All |
$34.34
|
| Rate for Payer: OMNI Networks Commercial |
$26.42
|
| Rate for Payer: One Health Plan PPO/POS |
$33.97
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$35.85
|
| Rate for Payer: Three Rivers Provider Network All |
$28.30
|
| Rate for Payer: United Payors & United Providers UP&UP |
$35.10
|
| Rate for Payer: Zelis Auto |
$15.10
|
| Rate for Payer: Zelis Worker's Compensation |
$10.30
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
9598966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.18 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22.16
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$34.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Humana ChoiceCare |
$11.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22.61
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25.80
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22.61
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$37.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22.61
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.50
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
24598966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$30.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
20398966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$30.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
20398966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.18 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22.16
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$34.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Humana ChoiceCare |
$11.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22.61
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25.80
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22.61
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$37.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22.61
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.50
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
21600517
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.18 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22.16
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$34.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Humana ChoiceCare |
$11.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22.61
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25.80
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22.61
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$37.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22.61
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.50
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
21900169
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$30.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
7998966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$30.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
21098966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.18 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$25.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22.16
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$34.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Humana ChoiceCare |
$11.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22.61
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$25.80
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22.61
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$37.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22.61
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.50
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
20598966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$83.27 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$259.25
|
| Rate for Payer: First Health Commercial |
$274.50
|
| Rate for Payer: First Health Workers Compensation |
$117.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$274.50
|
| Rate for Payer: GEHA Commercial |
$213.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$274.50
|
| Rate for Payer: Multiplan All |
$277.55
|
| Rate for Payer: OMNI Networks Commercial |
$213.50
|
| Rate for Payer: One Health Plan PPO/POS |
$274.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$289.75
|
| Rate for Payer: Three Rivers Provider Network All |
$228.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$283.65
|
| Rate for Payer: Zelis Auto |
$122.00
|
| Rate for Payer: Zelis Worker's Compensation |
$83.27
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
20598966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$22.16 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$183.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22.16
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$259.25
|
| Rate for Payer: First Health Commercial |
$274.50
|
| Rate for Payer: First Health Workers Compensation |
$117.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$274.50
|
| Rate for Payer: GEHA Commercial |
$244.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$274.50
|
| Rate for Payer: Humana ChoiceCare |
$79.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22.61
|
| Rate for Payer: Multiplan All |
$277.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$183.00
|
| Rate for Payer: OMNI Networks Commercial |
$213.50
|
| Rate for Payer: One Health Plan PPO/POS |
$274.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22.61
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$289.75
|
| Rate for Payer: Three Rivers Provider Network All |
$228.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$268.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22.61
|
| Rate for Payer: United Payors & United Providers UP&UP |
$283.65
|
| Rate for Payer: Zelis Auto |
$122.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$152.50
|
| Rate for Payer: Zelis Worker's Compensation |
$83.27
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
8599220
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$35.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$22.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22.16
|
| Rate for Payer: Cash Price |
$22.64
|
| Rate for Payer: Cash Price |
$22.64
|
| Rate for Payer: Cigna Commercial |
$32.08
|
| Rate for Payer: First Health Commercial |
$33.97
|
| Rate for Payer: First Health Workers Compensation |
$14.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$33.97
|
| Rate for Payer: GEHA Commercial |
$30.19
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$33.97
|
| Rate for Payer: Humana ChoiceCare |
$9.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$22.61
|
| Rate for Payer: Multiplan All |
$34.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22.64
|
| Rate for Payer: OMNI Networks Commercial |
$26.42
|
| Rate for Payer: One Health Plan PPO/POS |
$33.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$22.61
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$35.85
|
| Rate for Payer: Three Rivers Provider Network All |
$28.30
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$33.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$22.61
|
| Rate for Payer: United Payors & United Providers UP&UP |
$35.10
|
| Rate for Payer: Zelis Auto |
$15.10
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$18.87
|
| Rate for Payer: Zelis Worker's Compensation |
$10.30
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
24798966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$30.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
8298966
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$36.55
|
| Rate for Payer: First Health Commercial |
$38.70
|
| Rate for Payer: First Health Workers Compensation |
$16.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$38.70
|
| Rate for Payer: GEHA Commercial |
$30.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$38.70
|
| Rate for Payer: Multiplan All |
$39.13
|
| Rate for Payer: OMNI Networks Commercial |
$30.10
|
| Rate for Payer: One Health Plan PPO/POS |
$38.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$40.85
|
| Rate for Payer: Three Rivers Provider Network All |
$32.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$39.99
|
| Rate for Payer: Zelis Auto |
$17.20
|
| Rate for Payer: Zelis Worker's Compensation |
$11.74
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 M
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 98966
|
| Hospital Charge Code |
1900050
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$72.20 |
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cigna Commercial |
$64.60
|
| Rate for Payer: First Health Commercial |
$68.40
|
| Rate for Payer: First Health Workers Compensation |
$29.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$68.40
|
| Rate for Payer: GEHA Commercial |
$53.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$68.40
|
| Rate for Payer: Multiplan All |
$69.16
|
| Rate for Payer: OMNI Networks Commercial |
$53.20
|
| Rate for Payer: One Health Plan PPO/POS |
$68.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$72.20
|
| Rate for Payer: Three Rivers Provider Network All |
$57.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$70.68
|
| Rate for Payer: Zelis Auto |
$30.40
|
| Rate for Payer: Zelis Worker's Compensation |
$20.75
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 11-20 M
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 98967
|
| Hospital Charge Code |
21798967
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$22.39 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$69.70
|
| Rate for Payer: First Health Commercial |
$73.80
|
| Rate for Payer: First Health Workers Compensation |
$31.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$73.80
|
| Rate for Payer: GEHA Commercial |
$57.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$73.80
|
| Rate for Payer: Multiplan All |
$74.62
|
| Rate for Payer: OMNI Networks Commercial |
$57.40
|
| Rate for Payer: One Health Plan PPO/POS |
$73.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$77.90
|
| Rate for Payer: Three Rivers Provider Network All |
$61.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$76.26
|
| Rate for Payer: Zelis Auto |
$32.80
|
| Rate for Payer: Zelis Worker's Compensation |
$22.39
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 11-20 M
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 98967
|
| Hospital Charge Code |
21900170
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$22.39 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$69.70
|
| Rate for Payer: First Health Commercial |
$73.80
|
| Rate for Payer: First Health Workers Compensation |
$31.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$73.80
|
| Rate for Payer: GEHA Commercial |
$57.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$73.80
|
| Rate for Payer: Multiplan All |
$74.62
|
| Rate for Payer: OMNI Networks Commercial |
$57.40
|
| Rate for Payer: One Health Plan PPO/POS |
$73.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$77.90
|
| Rate for Payer: Three Rivers Provider Network All |
$61.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$76.26
|
| Rate for Payer: Zelis Auto |
$32.80
|
| Rate for Payer: Zelis Worker's Compensation |
$22.39
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 11-20 M
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 98967
|
| Hospital Charge Code |
21900170
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$21.32 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$51.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$49.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$51.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.15
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$69.70
|
| Rate for Payer: First Health Commercial |
$73.80
|
| Rate for Payer: First Health Workers Compensation |
$31.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$73.80
|
| Rate for Payer: GEHA Commercial |
$65.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$73.80
|
| Rate for Payer: Humana ChoiceCare |
$21.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$41.99
|
| Rate for Payer: Multiplan All |
$74.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.20
|
| Rate for Payer: OMNI Networks Commercial |
$57.40
|
| Rate for Payer: One Health Plan PPO/POS |
$73.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$48.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$41.99
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$77.90
|
| Rate for Payer: Three Rivers Provider Network All |
$61.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$72.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$41.99
|
| Rate for Payer: United Payors & United Providers UP&UP |
$76.26
|
| Rate for Payer: Zelis Auto |
$32.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$41.00
|
| Rate for Payer: Zelis Worker's Compensation |
$22.39
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 11-20 M
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 98967
|
| Hospital Charge Code |
21798967
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$21.32 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$51.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$49.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$51.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.15
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$69.70
|
| Rate for Payer: First Health Commercial |
$73.80
|
| Rate for Payer: First Health Workers Compensation |
$31.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$73.80
|
| Rate for Payer: GEHA Commercial |
$65.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$73.80
|
| Rate for Payer: Humana ChoiceCare |
$21.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$41.99
|
| Rate for Payer: Multiplan All |
$74.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.20
|
| Rate for Payer: OMNI Networks Commercial |
$57.40
|
| Rate for Payer: One Health Plan PPO/POS |
$73.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$48.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$41.99
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$77.90
|
| Rate for Payer: Three Rivers Provider Network All |
$61.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$72.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$41.99
|
| Rate for Payer: United Payors & United Providers UP&UP |
$76.26
|
| Rate for Payer: Zelis Auto |
$32.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$41.00
|
| Rate for Payer: Zelis Worker's Compensation |
$22.39
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 11-20 M
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 98967
|
| Hospital Charge Code |
8498967
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$22.39 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$69.70
|
| Rate for Payer: First Health Commercial |
$73.80
|
| Rate for Payer: First Health Workers Compensation |
$31.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$73.80
|
| Rate for Payer: GEHA Commercial |
$57.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$73.80
|
| Rate for Payer: Multiplan All |
$74.62
|
| Rate for Payer: OMNI Networks Commercial |
$57.40
|
| Rate for Payer: One Health Plan PPO/POS |
$73.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$77.90
|
| Rate for Payer: Three Rivers Provider Network All |
$61.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$76.26
|
| Rate for Payer: Zelis Auto |
$32.80
|
| Rate for Payer: Zelis Worker's Compensation |
$22.39
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 11-20 M
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 98967
|
| Hospital Charge Code |
8498967
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$21.32 |
| Max. Negotiated Rate |
$77.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$51.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$49.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$51.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.15
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cigna Commercial |
$69.70
|
| Rate for Payer: First Health Commercial |
$73.80
|
| Rate for Payer: First Health Workers Compensation |
$31.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$73.80
|
| Rate for Payer: GEHA Commercial |
$65.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$73.80
|
| Rate for Payer: Humana ChoiceCare |
$21.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$41.99
|
| Rate for Payer: Multiplan All |
$74.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.20
|
| Rate for Payer: OMNI Networks Commercial |
$57.40
|
| Rate for Payer: One Health Plan PPO/POS |
$73.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$48.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$41.99
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$77.90
|
| Rate for Payer: Three Rivers Provider Network All |
$61.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$72.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$41.99
|
| Rate for Payer: United Payors & United Providers UP&UP |
$76.26
|
| Rate for Payer: Zelis Auto |
$32.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$41.00
|
| Rate for Payer: Zelis Worker's Compensation |
$22.39
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 21-30 M
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
CPT 98968
|
| Hospital Charge Code |
8498968
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$115.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$71.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$71.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$56.80
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$103.70
|
| Rate for Payer: First Health Commercial |
$109.80
|
| Rate for Payer: First Health Workers Compensation |
$47.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$109.80
|
| Rate for Payer: GEHA Commercial |
$97.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$109.80
|
| Rate for Payer: Humana ChoiceCare |
$31.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$57.96
|
| Rate for Payer: Multiplan All |
$111.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$73.20
|
| Rate for Payer: OMNI Networks Commercial |
$85.40
|
| Rate for Payer: One Health Plan PPO/POS |
$109.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$66.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$57.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$115.90
|
| Rate for Payer: Three Rivers Provider Network All |
$91.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$107.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$57.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$113.46
|
| Rate for Payer: Zelis Auto |
$48.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$61.00
|
| Rate for Payer: Zelis Worker's Compensation |
$33.31
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 21-30 M
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
CPT 98968
|
| Hospital Charge Code |
8498968
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$115.90 |
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$103.70
|
| Rate for Payer: First Health Commercial |
$109.80
|
| Rate for Payer: First Health Workers Compensation |
$47.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$109.80
|
| Rate for Payer: GEHA Commercial |
$85.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$109.80
|
| Rate for Payer: Multiplan All |
$111.02
|
| Rate for Payer: OMNI Networks Commercial |
$85.40
|
| Rate for Payer: One Health Plan PPO/POS |
$109.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$115.90
|
| Rate for Payer: Three Rivers Provider Network All |
$91.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$113.46
|
| Rate for Payer: Zelis Auto |
$48.80
|
| Rate for Payer: Zelis Worker's Compensation |
$33.31
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 21-30 M
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
CPT 98968
|
| Hospital Charge Code |
21900171
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$115.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$71.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$71.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$56.80
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$103.70
|
| Rate for Payer: First Health Commercial |
$109.80
|
| Rate for Payer: First Health Workers Compensation |
$47.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$109.80
|
| Rate for Payer: GEHA Commercial |
$97.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$109.80
|
| Rate for Payer: Humana ChoiceCare |
$31.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$57.96
|
| Rate for Payer: Multiplan All |
$111.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$73.20
|
| Rate for Payer: OMNI Networks Commercial |
$85.40
|
| Rate for Payer: One Health Plan PPO/POS |
$109.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$66.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$57.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$115.90
|
| Rate for Payer: Three Rivers Provider Network All |
$91.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$107.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$57.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$113.46
|
| Rate for Payer: Zelis Auto |
$48.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$61.00
|
| Rate for Payer: Zelis Worker's Compensation |
$33.31
|
|
|
NONPHYSICIAN TELEPHONE ASSESSMNT 21-30 M
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
CPT 98968
|
| Hospital Charge Code |
21798968
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$115.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$71.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$71.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$56.80
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cigna Commercial |
$103.70
|
| Rate for Payer: First Health Commercial |
$109.80
|
| Rate for Payer: First Health Workers Compensation |
$47.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$109.80
|
| Rate for Payer: GEHA Commercial |
$97.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$109.80
|
| Rate for Payer: Humana ChoiceCare |
$31.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$57.96
|
| Rate for Payer: Multiplan All |
$111.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$73.20
|
| Rate for Payer: OMNI Networks Commercial |
$85.40
|
| Rate for Payer: One Health Plan PPO/POS |
$109.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$66.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$57.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$115.90
|
| Rate for Payer: Three Rivers Provider Network All |
$91.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$107.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$57.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$113.46
|
| Rate for Payer: Zelis Auto |
$48.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$61.00
|
| Rate for Payer: Zelis Worker's Compensation |
$33.31
|
|
