|
MOTOR SPEECH CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GN
|
| Hospital Charge Code |
9109151
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
MOTOR SPEECH CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GN
|
| Hospital Charge Code |
84201159
|
|
Hospital Revenue Code
|
449
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
MOTOR SPEECH CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GN
|
| Hospital Charge Code |
9109151
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
MOTOR SPEECH CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GN
|
| Hospital Charge Code |
84201010
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
MOTOR SPEECH CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GN
|
| Hospital Charge Code |
84201010
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech Current Status CH
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCH
|
| Hospital Charge Code |
74204053CH
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech Current Status CH
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCH
|
| Hospital Charge Code |
74204053CH
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
Motor Speech Current Status CI
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCI
|
| Hospital Charge Code |
74204053CI
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech Current Status CI
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCI
|
| Hospital Charge Code |
74204053CI
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
Motor Speech Current Status CJ
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCJ
|
| Hospital Charge Code |
74204053CJ
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
Motor Speech Current Status CJ
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCJ
|
| Hospital Charge Code |
74204053CJ
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech Current Status CK
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCK
|
| Hospital Charge Code |
74204053CK
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
Motor Speech Current Status CK
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCK
|
| Hospital Charge Code |
74204053CK
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech Current Status CL
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCL
|
| Hospital Charge Code |
74204053CL
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech Current Status CL
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCL
|
| Hospital Charge Code |
74204053CL
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
Motor Speech Current Status CM
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCM
|
| Hospital Charge Code |
74204053CM
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
Motor Speech Current Status CM
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCM
|
| Hospital Charge Code |
74204053CM
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech Current Status CN
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCN
|
| Hospital Charge Code |
74204053CN
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech Current Status CN
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8999GNCN
|
| Hospital Charge Code |
74204053CN
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
MOTOR SPEECH D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G9158GN
|
| Hospital Charge Code |
84201161
|
|
Hospital Revenue Code
|
449
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
MOTOR SPEECH D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G9158GN
|
| Hospital Charge Code |
84201161
|
|
Hospital Revenue Code
|
449
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
MOTOR SPEECH D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G9158GN
|
| Hospital Charge Code |
84201015
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
MOTOR SPEECH D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G9158GN
|
| Hospital Charge Code |
84201015
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech D/C Status CH
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G9158GNCH
|
| Hospital Charge Code |
74204057CH
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
Motor Speech D/C Status CH
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G9158GNCH
|
| Hospital Charge Code |
74204057CH
|
|
Hospital Revenue Code
|
440
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|