|
EAPG 806: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS AND COMPLICATIONS
|
Facility
|
OP
|
$284.87
|
|
|
Service Code
|
EAPG 0806
|
| Min. Negotiated Rate |
$126.61 |
| Max. Negotiated Rate |
$284.87 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$284.87
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$126.61
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$126.61
|
| Rate for Payer: CDPHP Essential Plan |
$284.87
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$151.93
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$126.61
|
| Rate for Payer: EmblemHealth Medicaid |
$126.61
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$284.87
|
| Rate for Payer: Hamaspik Choice Medicaid |
$126.61
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$126.61
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$272.21
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$272.21
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$126.61
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$132.94
|
|
|
EAPG 807: FEVER
|
Facility
|
OP
|
$261.61
|
|
|
Service Code
|
EAPG 0807
|
| Min. Negotiated Rate |
$116.27 |
| Max. Negotiated Rate |
$261.61 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$261.61
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$116.27
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$116.27
|
| Rate for Payer: CDPHP Essential Plan |
$261.61
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$139.52
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$116.27
|
| Rate for Payer: EmblemHealth Medicaid |
$116.27
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$261.61
|
| Rate for Payer: Hamaspik Choice Medicaid |
$116.27
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$116.27
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$249.98
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$249.98
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$116.27
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$122.08
|
|
|
EAPG 808: VIRAL ILLNESS
|
Facility
|
OP
|
$259.09
|
|
|
Service Code
|
EAPG 0808
|
| Min. Negotiated Rate |
$115.15 |
| Max. Negotiated Rate |
$259.09 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$259.09
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$115.15
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$115.15
|
| Rate for Payer: CDPHP Essential Plan |
$259.09
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$138.18
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$115.15
|
| Rate for Payer: EmblemHealth Medicaid |
$115.15
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$259.09
|
| Rate for Payer: Hamaspik Choice Medicaid |
$115.15
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$115.15
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$247.57
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$247.57
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$115.15
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$120.91
|
|
|
EAPG 809: OTHER INFECTIOUS AND PARASITIC DISEASES
|
Facility
|
OP
|
$245.50
|
|
|
Service Code
|
EAPG 0809
|
| Min. Negotiated Rate |
$109.11 |
| Max. Negotiated Rate |
$245.50 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$245.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$109.11
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$109.11
|
| Rate for Payer: CDPHP Essential Plan |
$245.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$130.93
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$109.11
|
| Rate for Payer: EmblemHealth Medicaid |
$109.11
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$245.50
|
| Rate for Payer: Hamaspik Choice Medicaid |
$109.11
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$109.11
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$234.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$234.59
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$109.11
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$114.57
|
|
|
EAPG 80: EXERCISE TOLERANCE TESTS
|
Facility
|
OP
|
$332.24
|
|
|
Service Code
|
EAPG 0080
|
| Min. Negotiated Rate |
$147.66 |
| Max. Negotiated Rate |
$332.24 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$332.24
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$147.66
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$147.66
|
| Rate for Payer: CDPHP Essential Plan |
$332.24
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$177.19
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$147.66
|
| Rate for Payer: EmblemHealth Medicaid |
$147.66
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$332.24
|
| Rate for Payer: Hamaspik Choice Medicaid |
$147.66
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$147.66
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$317.47
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$317.47
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$147.66
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$155.04
|
|
|
EAPG 810: H. PYLORI INFECTION
|
Facility
|
OP
|
$197.57
|
|
|
Service Code
|
EAPG 0810
|
| Min. Negotiated Rate |
$87.81 |
| Max. Negotiated Rate |
$197.57 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$197.57
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$87.81
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$87.81
|
| Rate for Payer: CDPHP Essential Plan |
$197.57
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$105.37
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$87.81
|
| Rate for Payer: EmblemHealth Medicaid |
$87.81
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$197.57
|
| Rate for Payer: Hamaspik Choice Medicaid |
$87.81
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$87.81
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$188.79
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$188.79
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$87.81
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$92.20
|
|
|
EAPG 812: VIRAL MENINGITIS
|
Facility
|
OP
|
$292.90
|
|
|
Service Code
|
EAPG 0812
|
| Min. Negotiated Rate |
$130.18 |
| Max. Negotiated Rate |
$292.90 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$292.90
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$130.18
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$130.18
|
| Rate for Payer: CDPHP Essential Plan |
$292.90
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$156.22
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$130.18
|
| Rate for Payer: EmblemHealth Medicaid |
$130.18
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$292.90
|
| Rate for Payer: Hamaspik Choice Medicaid |
$130.18
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$130.18
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$279.89
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$279.89
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$130.18
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$136.69
|
|
|
EAPG 81: ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$646.76
|
|
|
Service Code
|
EAPG 0081
|
| Min. Negotiated Rate |
$287.45 |
| Max. Negotiated Rate |
$646.76 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$646.76
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$287.45
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$287.45
|
| Rate for Payer: CDPHP Essential Plan |
$646.76
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$344.94
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$287.45
|
| Rate for Payer: EmblemHealth Medicaid |
$287.45
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$646.76
|
| Rate for Payer: Hamaspik Choice Medicaid |
$287.45
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$287.45
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$618.02
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$618.02
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$287.45
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$301.82
|
|
|
EAPG 820: SCHIZOPHRENIA
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0820
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 821: MAJOR DEPRESSIVE DIAGNOSES AND OTHER OR UNSPECIFIED PSYCHOSES
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0821
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 822: PERSONALITY AND IMPULSE CONTROL DIAGNOSES
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0822
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 823: BIPOLAR DISORDERS
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0823
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 824: DEPRESSION EXCEPT MAJOR DEPRESSIVE DIAGNOSES
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0824
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 825: ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0825
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 826: ACUTE ANXIETY AND DELIRIUM STATES
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0826
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 827: ORGANIC BEHAVIORAL HEALTH DISTURBANCES
|
Facility
|
OP
|
$295.40
|
|
|
Service Code
|
EAPG 0827
|
| Min. Negotiated Rate |
$131.29 |
| Max. Negotiated Rate |
$295.40 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$295.40
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$131.29
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$131.29
|
| Rate for Payer: CDPHP Essential Plan |
$295.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$157.55
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$131.29
|
| Rate for Payer: EmblemHealth Medicaid |
$131.29
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$295.40
|
| Rate for Payer: Hamaspik Choice Medicaid |
$131.29
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$131.29
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$282.27
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$282.27
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$131.29
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$137.85
|
|
|
EAPG 828: INTELLECTUAL DISABILITY
|
Facility
|
OP
|
$250.45
|
|
|
Service Code
|
EAPG 0828
|
| Min. Negotiated Rate |
$111.31 |
| Max. Negotiated Rate |
$250.45 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$250.45
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$111.31
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$111.31
|
| Rate for Payer: CDPHP Essential Plan |
$250.45
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$133.57
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$111.31
|
| Rate for Payer: EmblemHealth Medicaid |
$111.31
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$250.45
|
| Rate for Payer: Hamaspik Choice Medicaid |
$111.31
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$111.31
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$239.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$239.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$111.31
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$116.88
|
|
|
EAPG 829: CHILDHOOD BEHAVIORAL DIAGNOSES
|
Facility
|
OP
|
$250.34
|
|
|
Service Code
|
EAPG 0829
|
| Min. Negotiated Rate |
$111.26 |
| Max. Negotiated Rate |
$250.34 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$250.34
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$111.26
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$111.26
|
| Rate for Payer: CDPHP Essential Plan |
$250.34
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$133.51
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$111.26
|
| Rate for Payer: EmblemHealth Medicaid |
$111.26
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$250.34
|
| Rate for Payer: Hamaspik Choice Medicaid |
$111.26
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$111.26
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$239.21
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$239.21
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$111.26
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$116.82
|
|
|
EAPG 82: CARDIAC ELECTROPHYSIOLOGIC TESTS AND MONITORING
|
Facility
|
OP
|
$1,839.17
|
|
|
Service Code
|
EAPG 0082
|
| Min. Negotiated Rate |
$817.41 |
| Max. Negotiated Rate |
$1,839.17 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$1,839.17
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$817.41
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$817.41
|
| Rate for Payer: CDPHP Essential Plan |
$1,839.17
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$980.89
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$817.41
|
| Rate for Payer: EmblemHealth Medicaid |
$817.41
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$1,839.17
|
| Rate for Payer: Hamaspik Choice Medicaid |
$817.41
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$817.41
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$1,757.43
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$1,757.43
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$817.41
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$858.28
|
|
|
EAPG 830: EATING DISORDERS
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0830
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 831: OTHER BEHAVIORAL HEALTH DIAGNOSES
|
Facility
|
OP
|
$242.08
|
|
|
Service Code
|
EAPG 0831
|
| Min. Negotiated Rate |
$107.59 |
| Max. Negotiated Rate |
$242.08 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$242.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$107.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$107.59
|
| Rate for Payer: CDPHP Essential Plan |
$242.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$129.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.59
|
| Rate for Payer: EmblemHealth Medicaid |
$107.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$242.08
|
| Rate for Payer: Hamaspik Choice Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$107.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$231.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$231.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.97
|
|
|
EAPG 832: INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE
|
Facility
|
OP
|
$330.88
|
|
|
Service Code
|
EAPG 0832
|
| Min. Negotiated Rate |
$147.06 |
| Max. Negotiated Rate |
$330.88 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$330.88
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$147.06
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$147.06
|
| Rate for Payer: CDPHP Essential Plan |
$330.88
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$176.47
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$147.06
|
| Rate for Payer: EmblemHealth Medicaid |
$147.06
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$330.88
|
| Rate for Payer: Hamaspik Choice Medicaid |
$147.06
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$147.06
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$316.18
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$316.18
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$147.06
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$154.41
|
|
|
EAPG 83: LEVEL II CENTRAL VENOUS ACCESS PROCEDURES
|
Facility
|
OP
|
$2,767.75
|
|
|
Service Code
|
EAPG 0083
|
| Min. Negotiated Rate |
$1,230.11 |
| Max. Negotiated Rate |
$2,767.75 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$2,767.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$1,230.11
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$1,230.11
|
| Rate for Payer: CDPHP Essential Plan |
$2,767.75
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,476.13
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,230.11
|
| Rate for Payer: EmblemHealth Medicaid |
$1,230.11
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$2,767.75
|
| Rate for Payer: Hamaspik Choice Medicaid |
$1,230.11
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$1,230.11
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$2,644.74
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$2,644.74
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1,230.11
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$1,291.62
|
|
|
EAPG 840: OPIOID ABUSE AND DEPENDENCE
|
Facility
|
OP
|
$293.96
|
|
|
Service Code
|
EAPG 0840
|
| Min. Negotiated Rate |
$130.65 |
| Max. Negotiated Rate |
$293.96 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$293.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$130.65
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$130.65
|
| Rate for Payer: CDPHP Essential Plan |
$293.96
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$156.78
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$130.65
|
| Rate for Payer: EmblemHealth Medicaid |
$130.65
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$293.96
|
| Rate for Payer: Hamaspik Choice Medicaid |
$130.65
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$130.65
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$280.90
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$280.90
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$130.65
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$137.18
|
|
|
EAPG 841: COCAINE ABUSE AND DEPENDENCE
|
Facility
|
OP
|
$293.96
|
|
|
Service Code
|
EAPG 0841
|
| Min. Negotiated Rate |
$130.65 |
| Max. Negotiated Rate |
$293.96 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$293.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$130.65
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$130.65
|
| Rate for Payer: CDPHP Essential Plan |
$293.96
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$156.78
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$130.65
|
| Rate for Payer: EmblemHealth Medicaid |
$130.65
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$293.96
|
| Rate for Payer: Hamaspik Choice Medicaid |
$130.65
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$130.65
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$280.90
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$280.90
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$130.65
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$137.18
|
|
