|
PSY DX EVAL MD ADULT MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4822601
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD ADULT MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4502601
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4511610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4515610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4822629
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4822629
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
45187610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4511610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4546610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4515610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4517610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4504610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4535610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4504610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4509629
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4822610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4518610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4509629
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
45187610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4832610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$163.88 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,040.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$163.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.20
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$1,000.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
V
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4832610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
OP
|
$1,000.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
V
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$24.10 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$300.00
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.50
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4527610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSY DX EVAL MD CHILD MCAID
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
4535610
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
