|
EAPG 3033: INGUINAL, FEMORAL AND UMBILICAL HERNIA REPAIR
|
Facility
OP
|
$4,157.89
|
|
|
Service Code
|
EAPG 3033
|
| Min. Negotiated Rate |
$1,847.95 |
| Max. Negotiated Rate |
$4,157.89 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$4,157.89
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$1,847.95
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$1,847.95
|
| Rate for Payer: CDPHP Essential Plan |
$4,157.89
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$2,217.54
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,847.95
|
| Rate for Payer: EmblemHealth Medicaid |
$1,847.95
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$4,157.89
|
| Rate for Payer: Hamaspik Choice Medicaid |
$1,847.95
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$1,847.95
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$3,973.09
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$3,973.09
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1,847.95
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$1,940.35
|
|
|
EAPG 3035: ABDOMINAL HERNIA REPAIR
|
Facility
OP
|
$4,342.23
|
|
|
Service Code
|
EAPG 3035
|
| Min. Negotiated Rate |
$1,929.88 |
| Max. Negotiated Rate |
$4,342.23 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$4,342.23
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$1,929.88
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$1,929.88
|
| Rate for Payer: CDPHP Essential Plan |
$4,342.23
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$2,315.86
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,929.88
|
| Rate for Payer: EmblemHealth Medicaid |
$1,929.88
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$4,342.23
|
| Rate for Payer: Hamaspik Choice Medicaid |
$1,929.88
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$1,929.88
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$4,149.24
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$4,149.24
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1,929.88
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$2,026.37
|
|
|
EAPG 304: MINOR SPECIMEN COLLECTION SERVICES
|
Facility
OP
|
$79.42
|
|
|
Service Code
|
EAPG 0304
|
| Min. Negotiated Rate |
$35.30 |
| Max. Negotiated Rate |
$79.42 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$79.42
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$35.30
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$35.30
|
| Rate for Payer: CDPHP Essential Plan |
$79.42
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$42.36
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$35.30
|
| Rate for Payer: EmblemHealth Medicaid |
$35.30
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$79.42
|
| Rate for Payer: Hamaspik Choice Medicaid |
$35.30
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$35.30
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$75.90
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$75.90
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$35.30
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$37.06
|
|
|
EAPG 305: LEVEL I SURGICAL PATHOLOGY TESTS
|
Facility
OP
|
$113.13
|
|
|
Service Code
|
EAPG 0305
|
| Min. Negotiated Rate |
$50.28 |
| Max. Negotiated Rate |
$113.13 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$113.13
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$50.28
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$50.28
|
| Rate for Payer: CDPHP Essential Plan |
$113.13
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$60.34
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$50.28
|
| Rate for Payer: EmblemHealth Medicaid |
$50.28
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$113.13
|
| Rate for Payer: Hamaspik Choice Medicaid |
$50.28
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$50.28
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$108.10
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$108.10
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$50.28
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$52.79
|
|
|
EAPG 306: LEVEL II SURGICAL PATHOLOGY TESTS
|
Facility
OP
|
$159.44
|
|
|
Service Code
|
EAPG 0306
|
| Min. Negotiated Rate |
$70.86 |
| Max. Negotiated Rate |
$159.44 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$159.44
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$70.86
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$70.86
|
| Rate for Payer: CDPHP Essential Plan |
$159.44
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$85.03
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$70.86
|
| Rate for Payer: EmblemHealth Medicaid |
$70.86
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$159.44
|
| Rate for Payer: Hamaspik Choice Medicaid |
$70.86
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$70.86
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$152.35
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$152.35
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$70.86
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$74.40
|
|
|
EAPG 307: INSERTION OR REMOVAL OF DRUG DELIVERY DEVICE
|
Facility
OP
|
$642.31
|
|
|
Service Code
|
EAPG 0307
|
| Min. Negotiated Rate |
$285.47 |
| Max. Negotiated Rate |
$642.31 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$642.31
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$285.47
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$285.47
|
| Rate for Payer: CDPHP Essential Plan |
$642.31
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$342.56
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$285.47
|
| Rate for Payer: EmblemHealth Medicaid |
$285.47
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$642.31
|
| Rate for Payer: Hamaspik Choice Medicaid |
$285.47
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$285.47
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$613.76
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$613.76
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$285.47
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$299.74
|
|
|
EAPG 308: LEVEL III PATHOLOGY TESTS
|
Facility
OP
|
$170.19
|
|
|
Service Code
|
EAPG 0308
|
| Min. Negotiated Rate |
$75.64 |
| Max. Negotiated Rate |
$170.19 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$170.19
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$75.64
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$75.64
|
| Rate for Payer: CDPHP Essential Plan |
$170.19
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$90.77
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$75.64
|
| Rate for Payer: EmblemHealth Medicaid |
$75.64
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$170.19
|
| Rate for Payer: Hamaspik Choice Medicaid |
$75.64
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$75.64
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$162.63
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$162.63
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$75.64
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$79.42
|
|
|
EAPG 310: DEVELOPMENTAL & NEUROPSYCHOLOGICAL TESTING
|
Facility
OP
|
$302.60
|
|
|
Service Code
|
EAPG 0310
|
| Min. Negotiated Rate |
$134.49 |
| Max. Negotiated Rate |
$302.60 |
| Rate for Payer: Hamaspik Choice Medicaid |
$134.49
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$302.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$134.49
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$134.49
|
| Rate for Payer: CDPHP Essential Plan |
$302.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$161.39
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$134.49
|
| Rate for Payer: EmblemHealth Medicaid |
$134.49
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$302.60
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$134.49
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$289.15
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$289.15
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$134.49
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$141.21
|
|
|
EAPG 315: COUNSELLING OR INDIVIDUAL BRIEF PSYCHOTHERAPY
|
Facility
OP
|
$226.96
|
|
|
Service Code
|
EAPG 0315
|
| Min. Negotiated Rate |
$100.87 |
| Max. Negotiated Rate |
$226.96 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$226.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$100.87
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$100.87
|
| Rate for Payer: CDPHP Essential Plan |
$226.96
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$121.04
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$100.87
|
| Rate for Payer: EmblemHealth Medicaid |
$100.87
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$226.96
|
| Rate for Payer: Hamaspik Choice Medicaid |
$100.87
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$100.87
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$216.87
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$216.87
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$100.87
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$105.91
|
|
|
EAPG 316: INDIVIDUAL COMPREHENSIVE PSYCHOTHERAPY
|
Facility
OP
|
$302.60
|
|
|
Service Code
|
EAPG 0316
|
| Min. Negotiated Rate |
$134.49 |
| Max. Negotiated Rate |
$302.60 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$302.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$134.49
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$134.49
|
| Rate for Payer: CDPHP Essential Plan |
$302.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$161.39
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$134.49
|
| Rate for Payer: EmblemHealth Medicaid |
$134.49
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$302.60
|
| Rate for Payer: Hamaspik Choice Medicaid |
$134.49
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$134.49
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$289.15
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$289.15
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$134.49
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$141.21
|
|
|
EAPG 317: FAMILY PSYCHOTHERAPY
|
Facility
OP
|
$226.96
|
|
|
Service Code
|
EAPG 0317
|
| Min. Negotiated Rate |
$100.87 |
| Max. Negotiated Rate |
$226.96 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$226.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$100.87
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$100.87
|
| Rate for Payer: CDPHP Essential Plan |
$226.96
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$121.04
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$100.87
|
| Rate for Payer: EmblemHealth Medicaid |
$100.87
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$226.96
|
| Rate for Payer: Hamaspik Choice Medicaid |
$100.87
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$100.87
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$216.87
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$216.87
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$100.87
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$105.91
|
|
|
EAPG 318: GROUP PSYCHOTHERAPY
|
Facility
OP
|
$117.25
|
|
|
Service Code
|
EAPG 0318
|
| Min. Negotiated Rate |
$52.11 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$117.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$52.11
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$52.11
|
| Rate for Payer: CDPHP Essential Plan |
$117.25
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$62.53
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$52.11
|
| Rate for Payer: EmblemHealth Medicaid |
$52.11
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$117.25
|
| Rate for Payer: Hamaspik Choice Medicaid |
$52.11
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$52.11
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$112.04
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$112.04
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$52.11
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$54.72
|
|
|
EAPG 321: CRISIS INTERVENTION
|
Facility
OP
|
$302.60
|
|
|
Service Code
|
EAPG 0321
|
| Min. Negotiated Rate |
$134.49 |
| Max. Negotiated Rate |
$302.60 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$302.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$134.49
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$134.49
|
| Rate for Payer: CDPHP Essential Plan |
$302.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$161.39
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$134.49
|
| Rate for Payer: EmblemHealth Medicaid |
$134.49
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$302.60
|
| Rate for Payer: Hamaspik Choice Medicaid |
$134.49
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$134.49
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$289.15
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$289.15
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$134.49
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$141.21
|
|
|
EAPG 322: MEDICATION ADMINISTRATION & OBSERVATION
|
Facility
OP
|
$43.11
|
|
|
Service Code
|
EAPG 0322
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$43.11 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$43.11
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$19.16
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$19.16
|
| Rate for Payer: CDPHP Essential Plan |
$43.11
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$22.99
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$19.16
|
| Rate for Payer: EmblemHealth Medicaid |
$19.16
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$43.11
|
| Rate for Payer: Hamaspik Choice Medicaid |
$19.16
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$19.16
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$41.19
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$41.19
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$19.16
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$20.12
|
|
|
EAPG 323: BEHAVIORAL HEATLH ASSESSMENT
|
Facility
OP
|
$378.25
|
|
|
Service Code
|
EAPG 0323
|
| Min. Negotiated Rate |
$168.11 |
| Max. Negotiated Rate |
$378.25 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$378.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$168.11
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$168.11
|
| Rate for Payer: CDPHP Essential Plan |
$378.25
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$201.73
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$168.11
|
| Rate for Payer: EmblemHealth Medicaid |
$168.11
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$378.25
|
| Rate for Payer: Hamaspik Choice Medicaid |
$168.11
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$168.11
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$361.44
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$361.44
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$168.11
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$176.52
|
|
|
EAPG 324: SCREENING FOR BEHAVIORAL CHANGE OR RISK ASSESSMENT
|
Facility
OP
|
$102.51
|
|
|
Service Code
|
EAPG 0324
|
| Min. Negotiated Rate |
$45.56 |
| Max. Negotiated Rate |
$102.51 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$102.51
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$45.56
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$45.56
|
| Rate for Payer: CDPHP Essential Plan |
$102.51
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$54.67
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$45.56
|
| Rate for Payer: EmblemHealth Medicaid |
$45.56
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$102.51
|
| Rate for Payer: Hamaspik Choice Medicaid |
$45.56
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$45.56
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$97.95
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$97.95
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$45.56
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$47.84
|
|
|
EAPG 327: INTENSIVE OUTPATIENT PSYCHIATRIC TREATMENT
|
Facility
OP
|
$222.80
|
|
|
Service Code
|
EAPG 0327
|
| Min. Negotiated Rate |
$99.02 |
| Max. Negotiated Rate |
$222.80 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$222.80
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$99.02
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$99.02
|
| Rate for Payer: CDPHP Essential Plan |
$222.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$118.82
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$99.02
|
| Rate for Payer: EmblemHealth Medicaid |
$99.02
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$222.80
|
| Rate for Payer: Hamaspik Choice Medicaid |
$99.02
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$99.02
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$212.89
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$212.89
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$99.02
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$103.97
|
|
|
EAPG 328: DAY REHABILITATION, HALF DAY
|
Facility
OP
|
$180.54
|
|
|
Service Code
|
EAPG 0328
|
| Min. Negotiated Rate |
$80.24 |
| Max. Negotiated Rate |
$180.54 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$180.54
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$80.24
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$80.24
|
| Rate for Payer: CDPHP Essential Plan |
$180.54
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$96.29
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$80.24
|
| Rate for Payer: EmblemHealth Medicaid |
$80.24
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$180.54
|
| Rate for Payer: Hamaspik Choice Medicaid |
$80.24
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$80.24
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$172.52
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$172.52
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$80.24
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$84.25
|
|
|
EAPG 329: DAY REHABILITATION, FULL DAY
|
Facility
OP
|
$240.73
|
|
|
Service Code
|
EAPG 0329
|
| Min. Negotiated Rate |
$106.99 |
| Max. Negotiated Rate |
$240.73 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$240.73
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$106.99
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$106.99
|
| Rate for Payer: CDPHP Essential Plan |
$240.73
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$128.39
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$106.99
|
| Rate for Payer: EmblemHealth Medicaid |
$106.99
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$240.73
|
| Rate for Payer: Hamaspik Choice Medicaid |
$106.99
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$106.99
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$230.03
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$230.03
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$106.99
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.34
|
|
|
EAPG 331: LEVEL I DIAGNOSTIC NUCLEAR MEDICINE
|
Facility
OP
|
$681.88
|
|
|
Service Code
|
EAPG 0331
|
| Min. Negotiated Rate |
$303.06 |
| Max. Negotiated Rate |
$681.88 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$681.88
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$303.06
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$303.06
|
| Rate for Payer: CDPHP Essential Plan |
$681.88
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$363.67
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$303.06
|
| Rate for Payer: EmblemHealth Medicaid |
$303.06
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$681.88
|
| Rate for Payer: Hamaspik Choice Medicaid |
$303.06
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$303.06
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$651.58
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$651.58
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$303.06
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$318.21
|
|
|
EAPG 332: LEVEL II DIAGNOSTIC NUCLEAR MEDICINE
|
Facility
OP
|
$1,488.15
|
|
|
Service Code
|
EAPG 0332
|
| Min. Negotiated Rate |
$661.40 |
| Max. Negotiated Rate |
$1,488.15 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$1,488.15
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$661.40
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$661.40
|
| Rate for Payer: CDPHP Essential Plan |
$1,488.15
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$793.68
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$661.40
|
| Rate for Payer: EmblemHealth Medicaid |
$661.40
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$1,488.15
|
| Rate for Payer: Hamaspik Choice Medicaid |
$661.40
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$661.40
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$1,422.01
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$1,422.01
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$661.40
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$694.47
|
|
|
EAPG 333: BEHAVIORAL HEALTH RESIDENTIAL TREATMENT
|
Facility
OP
|
$240.73
|
|
|
Service Code
|
EAPG 0333
|
| Min. Negotiated Rate |
$106.99 |
| Max. Negotiated Rate |
$240.73 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$240.73
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$106.99
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$106.99
|
| Rate for Payer: CDPHP Essential Plan |
$240.73
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$128.39
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$106.99
|
| Rate for Payer: EmblemHealth Medicaid |
$106.99
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$240.73
|
| Rate for Payer: Hamaspik Choice Medicaid |
$106.99
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$106.99
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$230.03
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$230.03
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$106.99
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.34
|
|
|
EAPG 334: LEVEL I DEVICE PLACEMENT FOR RADIATION THERAPY
|
Facility
OP
|
$1,656.16
|
|
|
Service Code
|
EAPG 0334
|
| Min. Negotiated Rate |
$736.07 |
| Max. Negotiated Rate |
$1,656.16 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$1,656.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$736.07
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$736.07
|
| Rate for Payer: CDPHP Essential Plan |
$1,656.16
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$883.28
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$736.07
|
| Rate for Payer: EmblemHealth Medicaid |
$736.07
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$1,656.16
|
| Rate for Payer: Hamaspik Choice Medicaid |
$736.07
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$736.07
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$1,582.55
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$1,582.55
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$736.07
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$772.87
|
|
|
EAPG 335: LEVEL I BRACHYTHERAPY SOURCES
|
Facility
OP
|
$1,967.02
|
|
|
Service Code
|
EAPG 0335
|
| Min. Negotiated Rate |
$874.23 |
| Max. Negotiated Rate |
$1,967.02 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$1,967.02
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$874.23
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$874.23
|
| Rate for Payer: CDPHP Essential Plan |
$1,967.02
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,049.08
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$874.23
|
| Rate for Payer: EmblemHealth Medicaid |
$874.23
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$1,967.02
|
| Rate for Payer: Hamaspik Choice Medicaid |
$874.23
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$874.23
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$1,879.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$1,879.59
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$874.23
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$917.94
|
|
|
EAPG 336: LEVEL II BRACHYTHERAPY SOURCES
|
Facility
OP
|
$2,753.82
|
|
|
Service Code
|
EAPG 0336
|
| Min. Negotiated Rate |
$1,223.92 |
| Max. Negotiated Rate |
$2,753.82 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$2,753.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$1,223.92
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$1,223.92
|
| Rate for Payer: CDPHP Essential Plan |
$2,753.82
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,468.70
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,223.92
|
| Rate for Payer: EmblemHealth Medicaid |
$1,223.92
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$2,753.82
|
| Rate for Payer: Hamaspik Choice Medicaid |
$1,223.92
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$1,223.92
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$2,631.43
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$2,631.43
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1,223.92
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$1,285.12
|
|
