|
EAPG 581: PULMONARY INFECTION DIAGNOSES INCLUDING PNEUMONIA
|
Facility
OP
|
$318.76
|
|
|
Service Code
|
EAPG 0581
|
| Min. Negotiated Rate |
$141.67 |
| Max. Negotiated Rate |
$318.76 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$318.76
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$141.67
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$141.67
|
| Rate for Payer: CDPHP Essential Plan |
$318.76
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$170.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$141.67
|
| Rate for Payer: EmblemHealth Medicaid |
$141.67
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$318.76
|
| Rate for Payer: Hamaspik Choice Medicaid |
$141.67
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$141.67
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$304.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$304.59
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$141.67
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$148.75
|
|
|
EAPG 582: INTERSTITIAL AND ALVEOLAR LUNG DIAGNOSES
|
Facility
OP
|
$340.06
|
|
|
Service Code
|
EAPG 0582
|
| Min. Negotiated Rate |
$151.14 |
| Max. Negotiated Rate |
$340.06 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$340.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$151.14
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$151.14
|
| Rate for Payer: CDPHP Essential Plan |
$340.06
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$181.37
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$151.14
|
| Rate for Payer: EmblemHealth Medicaid |
$151.14
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$340.06
|
| Rate for Payer: Hamaspik Choice Medicaid |
$151.14
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$151.14
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$324.95
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$324.95
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$151.14
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$158.70
|
|
|
EAPG 583: MALFUNCTION, REACTION, OR COMPLICATION OF PULMONARY DEVICE OR PROCEDURE
|
Facility
OP
|
$303.21
|
|
|
Service Code
|
EAPG 0583
|
| Min. Negotiated Rate |
$134.76 |
| Max. Negotiated Rate |
$303.21 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$303.21
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$134.76
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$134.76
|
| Rate for Payer: CDPHP Essential Plan |
$303.21
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$161.71
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$134.76
|
| Rate for Payer: EmblemHealth Medicaid |
$134.76
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$303.21
|
| Rate for Payer: Hamaspik Choice Medicaid |
$134.76
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$134.76
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$289.73
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$289.73
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$134.76
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$141.50
|
|
|
EAPG 584: ACUTE BRONCHITIS
|
Facility
OP
|
$302.78
|
|
|
Service Code
|
EAPG 0584
|
| Min. Negotiated Rate |
$134.57 |
| Max. Negotiated Rate |
$302.78 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$302.78
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$134.57
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$134.57
|
| Rate for Payer: CDPHP Essential Plan |
$302.78
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$161.48
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$134.57
|
| Rate for Payer: EmblemHealth Medicaid |
$134.57
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$302.78
|
| Rate for Payer: Hamaspik Choice Medicaid |
$134.57
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$134.57
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$289.33
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$289.33
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$134.57
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$141.30
|
|
|
EAPG 585: AFTERCARE, OPEN WOUNDS AND OTHER TRAUMATIC INJURIES
|
Facility
OP
|
$312.75
|
|
|
Service Code
|
EAPG 0585
|
| Min. Negotiated Rate |
$139.00 |
| Max. Negotiated Rate |
$312.75 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$312.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$139.00
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$139.00
|
| Rate for Payer: CDPHP Essential Plan |
$312.75
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$166.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$139.00
|
| Rate for Payer: EmblemHealth Medicaid |
$139.00
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$312.75
|
| Rate for Payer: Hamaspik Choice Medicaid |
$139.00
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$139.00
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$298.85
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$298.85
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$139.00
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$145.95
|
|
|
EAPG 586: PULMONARY EMBOLISM
|
Facility
OP
|
$294.77
|
|
|
Service Code
|
EAPG 0586
|
| Min. Negotiated Rate |
$131.01 |
| Max. Negotiated Rate |
$294.77 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$294.77
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$131.01
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$131.01
|
| Rate for Payer: CDPHP Essential Plan |
$294.77
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$157.21
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$131.01
|
| Rate for Payer: EmblemHealth Medicaid |
$131.01
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$294.77
|
| Rate for Payer: Hamaspik Choice Medicaid |
$131.01
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$131.01
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$281.67
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$281.67
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$131.01
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$137.56
|
|
|
EAPG 587: RESPIRATORY FAILURE
|
Facility
OP
|
$282.56
|
|
|
Service Code
|
EAPG 0587
|
| Min. Negotiated Rate |
$125.58 |
| Max. Negotiated Rate |
$282.56 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$282.56
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$125.58
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$125.58
|
| Rate for Payer: CDPHP Essential Plan |
$282.56
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$150.70
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$125.58
|
| Rate for Payer: EmblemHealth Medicaid |
$125.58
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$282.56
|
| Rate for Payer: Hamaspik Choice Medicaid |
$125.58
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$125.58
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$270.00
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$270.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$125.58
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$131.86
|
|
|
EAPG 589: MALFUNCTION, REACTION, OR COMPLICATION OF CARDIOVASCULAR DEVICE OR PROC
|
Facility
OP
|
$299.23
|
|
|
Service Code
|
EAPG 0589
|
| Min. Negotiated Rate |
$132.99 |
| Max. Negotiated Rate |
$299.23 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$299.23
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$132.99
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$132.99
|
| Rate for Payer: CDPHP Essential Plan |
$299.23
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$159.59
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$132.99
|
| Rate for Payer: EmblemHealth Medicaid |
$132.99
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$299.23
|
| Rate for Payer: Hamaspik Choice Medicaid |
$132.99
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$132.99
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$285.93
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$285.93
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$132.99
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$139.64
|
|
|
EAPG 58: LEVEL II SHOULDER AND UPPER ARM PROCEDURES
|
Facility
OP
|
$4,546.48
|
|
|
Service Code
|
EAPG 0058
|
| Min. Negotiated Rate |
$2,020.66 |
| Max. Negotiated Rate |
$4,546.48 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$4,546.48
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$2,020.66
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$2,020.66
|
| Rate for Payer: CDPHP Essential Plan |
$4,546.48
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$2,424.79
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$2,020.66
|
| Rate for Payer: EmblemHealth Medicaid |
$2,020.66
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$4,546.48
|
| Rate for Payer: Hamaspik Choice Medicaid |
$2,020.66
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$2,020.66
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$4,344.42
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$4,344.42
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$2,020.66
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$2,121.69
|
|
|
EAPG 591: ACUTE MYOCARDIAL INFARCTION
|
Facility
OP
|
$538.92
|
|
|
Service Code
|
EAPG 0591
|
| Min. Negotiated Rate |
$239.52 |
| Max. Negotiated Rate |
$538.92 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$538.92
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$239.52
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$239.52
|
| Rate for Payer: CDPHP Essential Plan |
$538.92
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$287.42
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$239.52
|
| Rate for Payer: EmblemHealth Medicaid |
$239.52
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$538.92
|
| Rate for Payer: Hamaspik Choice Medicaid |
$239.52
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$239.52
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$514.97
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$514.97
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$239.52
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$251.50
|
|
|
EAPG 592: OTHER CARDIOVASCULAR SYSTEM DIAGNOSES
|
Facility
OP
|
$260.01
|
|
|
Service Code
|
EAPG 0592
|
| Min. Negotiated Rate |
$115.56 |
| Max. Negotiated Rate |
$260.01 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$260.01
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$115.56
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$115.56
|
| Rate for Payer: CDPHP Essential Plan |
$260.01
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$138.67
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$115.56
|
| Rate for Payer: EmblemHealth Medicaid |
$115.56
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$260.01
|
| Rate for Payer: Hamaspik Choice Medicaid |
$115.56
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$115.56
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$248.45
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$248.45
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$115.56
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$121.34
|
|
|
EAPG 594: HEART FAILURE
|
Facility
OP
|
$275.83
|
|
|
Service Code
|
EAPG 0594
|
| Min. Negotiated Rate |
$122.59 |
| Max. Negotiated Rate |
$275.83 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$275.83
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$122.59
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$122.59
|
| Rate for Payer: CDPHP Essential Plan |
$275.83
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$147.11
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$122.59
|
| Rate for Payer: EmblemHealth Medicaid |
$122.59
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$275.83
|
| Rate for Payer: Hamaspik Choice Medicaid |
$122.59
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$122.59
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$263.57
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$263.57
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$122.59
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$128.72
|
|
|
EAPG 595: CARDIAC ARREST OR OTHER CAUSES OF MORTALITY
|
Facility
OP
|
$596.00
|
|
|
Service Code
|
EAPG 0595
|
| Min. Negotiated Rate |
$264.89 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$596.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$264.89
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$264.89
|
| Rate for Payer: CDPHP Essential Plan |
$596.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$317.87
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$264.89
|
| Rate for Payer: EmblemHealth Medicaid |
$264.89
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$596.00
|
| Rate for Payer: Hamaspik Choice Medicaid |
$264.89
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$264.89
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$569.51
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$569.51
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$264.89
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$278.13
|
|
|
EAPG 596: PERIPHERAL AND OTHER VASCULAR DIAGNOSES
|
Facility
OP
|
$276.52
|
|
|
Service Code
|
EAPG 0596
|
| Min. Negotiated Rate |
$122.90 |
| Max. Negotiated Rate |
$276.52 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$276.52
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$122.90
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$122.90
|
| Rate for Payer: CDPHP Essential Plan |
$276.52
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$147.48
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$122.90
|
| Rate for Payer: EmblemHealth Medicaid |
$122.90
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$276.52
|
| Rate for Payer: Hamaspik Choice Medicaid |
$122.90
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$122.90
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$264.24
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$264.24
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$122.90
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$129.04
|
|
|
EAPG 597: PHLEBITIS
|
Facility
OP
|
$240.05
|
|
|
Service Code
|
EAPG 0597
|
| Min. Negotiated Rate |
$106.69 |
| Max. Negotiated Rate |
$240.05 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$240.05
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$106.69
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$106.69
|
| Rate for Payer: CDPHP Essential Plan |
$240.05
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$128.03
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$106.69
|
| Rate for Payer: EmblemHealth Medicaid |
$106.69
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$240.05
|
| Rate for Payer: Hamaspik Choice Medicaid |
$106.69
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$106.69
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$229.38
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$229.38
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$106.69
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$112.02
|
|
|
EAPG 598: ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
OP
|
$252.83
|
|
|
Service Code
|
EAPG 0598
|
| Min. Negotiated Rate |
$112.37 |
| Max. Negotiated Rate |
$252.83 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$252.83
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$112.37
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$112.37
|
| Rate for Payer: CDPHP Essential Plan |
$252.83
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$134.84
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$112.37
|
| Rate for Payer: EmblemHealth Medicaid |
$112.37
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$252.83
|
| Rate for Payer: Hamaspik Choice Medicaid |
$112.37
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$112.37
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$241.60
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$241.60
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$112.37
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$117.99
|
|
|
EAPG 599: HYPERTENSION
|
Facility
OP
|
$237.24
|
|
|
Service Code
|
EAPG 0599
|
| Min. Negotiated Rate |
$105.44 |
| Max. Negotiated Rate |
$237.24 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$237.24
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$105.44
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$105.44
|
| Rate for Payer: CDPHP Essential Plan |
$237.24
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$126.53
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$105.44
|
| Rate for Payer: EmblemHealth Medicaid |
$105.44
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$237.24
|
| Rate for Payer: Hamaspik Choice Medicaid |
$105.44
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$105.44
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$226.70
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$226.70
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$105.44
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$110.71
|
|
|
EAPG 59: ARTERIOVENOUS FISTULA CREATION OR REVISION FOR HEMODIALYSIS
|
Facility
OP
|
$5,065.38
|
|
|
Service Code
|
EAPG 0059
|
| Min. Negotiated Rate |
$2,251.28 |
| Max. Negotiated Rate |
$5,065.38 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$5,065.38
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$2,251.28
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$2,251.28
|
| Rate for Payer: CDPHP Essential Plan |
$5,065.38
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$2,701.54
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$2,251.28
|
| Rate for Payer: EmblemHealth Medicaid |
$2,251.28
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$5,065.38
|
| Rate for Payer: Hamaspik Choice Medicaid |
$2,251.28
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$2,251.28
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$4,840.25
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$4,840.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$2,251.28
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$2,363.84
|
|
|
EAPG 5: NAIL PROCEDURES
|
Facility
OP
|
$183.15
|
|
|
Service Code
|
EAPG 0005
|
| Min. Negotiated Rate |
$81.40 |
| Max. Negotiated Rate |
$183.15 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$183.15
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$81.40
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$81.40
|
| Rate for Payer: CDPHP Essential Plan |
$183.15
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$97.68
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$81.40
|
| Rate for Payer: EmblemHealth Medicaid |
$81.40
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$183.15
|
| Rate for Payer: Hamaspik Choice Medicaid |
$81.40
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$81.40
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$175.01
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$175.01
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$81.40
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$85.47
|
|
|
EAPG 600: CARDIAC STRUCTURAL AND VALVULAR DIAGNOSES
|
Facility
OP
|
$316.06
|
|
|
Service Code
|
EAPG 0600
|
| Min. Negotiated Rate |
$140.47 |
| Max. Negotiated Rate |
$316.06 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$316.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$140.47
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$140.47
|
| Rate for Payer: CDPHP Essential Plan |
$316.06
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$168.56
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$140.47
|
| Rate for Payer: EmblemHealth Medicaid |
$140.47
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$316.06
|
| Rate for Payer: Hamaspik Choice Medicaid |
$140.47
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$140.47
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$302.01
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$302.01
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$140.47
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$147.49
|
|
|
EAPG 601: CARDIAC ARRHYTHMIA AND CONDUCTION DIAGNOSES
|
Facility
OP
|
$283.72
|
|
|
Service Code
|
EAPG 0601
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$283.72 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$283.72
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$126.10
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$126.10
|
| Rate for Payer: CDPHP Essential Plan |
$283.72
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$151.32
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$126.10
|
| Rate for Payer: EmblemHealth Medicaid |
$126.10
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$283.72
|
| Rate for Payer: Hamaspik Choice Medicaid |
$126.10
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$126.10
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$271.12
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$271.12
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$126.10
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$132.40
|
|
|
EAPG 602: ATRIAL FIBRILLATION
|
Facility
OP
|
$255.06
|
|
|
Service Code
|
EAPG 0602
|
| Min. Negotiated Rate |
$113.36 |
| Max. Negotiated Rate |
$255.06 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$255.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$113.36
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$113.36
|
| Rate for Payer: CDPHP Essential Plan |
$255.06
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$136.03
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$113.36
|
| Rate for Payer: EmblemHealth Medicaid |
$113.36
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$255.06
|
| Rate for Payer: Hamaspik Choice Medicaid |
$113.36
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$113.36
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$243.72
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$243.72
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$113.36
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$119.03
|
|
|
EAPG 604: CHEST PAIN
|
Facility
OP
|
$334.17
|
|
|
Service Code
|
EAPG 0604
|
| Min. Negotiated Rate |
$148.52 |
| Max. Negotiated Rate |
$334.17 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$334.17
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$148.52
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$148.52
|
| Rate for Payer: CDPHP Essential Plan |
$334.17
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$178.22
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$148.52
|
| Rate for Payer: EmblemHealth Medicaid |
$148.52
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$334.17
|
| Rate for Payer: Hamaspik Choice Medicaid |
$148.52
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$148.52
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$319.32
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$319.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$148.52
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$155.95
|
|
|
EAPG 605: SYNCOPE AND COLLAPSE
|
Facility
OP
|
$300.62
|
|
|
Service Code
|
EAPG 0605
|
| Min. Negotiated Rate |
$133.61 |
| Max. Negotiated Rate |
$300.62 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$300.62
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$133.61
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$133.61
|
| Rate for Payer: CDPHP Essential Plan |
$300.62
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$160.33
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$133.61
|
| Rate for Payer: EmblemHealth Medicaid |
$133.61
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$300.62
|
| Rate for Payer: Hamaspik Choice Medicaid |
$133.61
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$133.61
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$287.26
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$287.26
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$133.61
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$140.29
|
|
|
EAPG 607: CARDIOMYOPATHY DIAGNOSES
|
Facility
OP
|
$264.38
|
|
|
Service Code
|
EAPG 0607
|
| Min. Negotiated Rate |
$117.50 |
| Max. Negotiated Rate |
$264.38 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$264.38
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$117.50
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$117.50
|
| Rate for Payer: CDPHP Essential Plan |
$264.38
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$141.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$117.50
|
| Rate for Payer: EmblemHealth Medicaid |
$117.50
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$264.38
|
| Rate for Payer: Hamaspik Choice Medicaid |
$117.50
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$117.50
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$252.62
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$252.62
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$117.50
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$123.38
|
|
