|
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 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
|
|
|
EAPG 842: ALCOHOL ABUSE AND DEPENDENCE
|
Facility
OP
|
$293.96
|
|
|
Service Code
|
EAPG 0842
|
| 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 843: OTHER DRUG ABUSE AND DEPENDENCE
|
Facility
OP
|
$293.96
|
|
|
Service Code
|
EAPG 0843
|
| 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 84: DIAGNOSTIC CARDIAC CATHETERIZATION
|
Facility
OP
|
$3,591.02
|
|
|
Service Code
|
EAPG 0084
|
| Min. Negotiated Rate |
$1,596.01 |
| Max. Negotiated Rate |
$3,591.02 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$3,591.02
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$1,596.01
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$1,596.01
|
| Rate for Payer: CDPHP Essential Plan |
$3,591.02
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,915.21
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,596.01
|
| Rate for Payer: EmblemHealth Medicaid |
$1,596.01
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$3,591.02
|
| Rate for Payer: Hamaspik Choice Medicaid |
$1,596.01
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$1,596.01
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$3,431.42
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$3,431.42
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1,596.01
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$1,675.81
|
|
|
EAPG 850: ALLERGIC REACTIONS
|
Facility
OP
|
$318.71
|
|
|
Service Code
|
EAPG 0850
|
| Min. Negotiated Rate |
$141.65 |
| Max. Negotiated Rate |
$318.71 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$318.71
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$141.65
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$141.65
|
| Rate for Payer: CDPHP Essential Plan |
$318.71
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$169.98
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$141.65
|
| Rate for Payer: EmblemHealth Medicaid |
$141.65
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$318.71
|
| Rate for Payer: Hamaspik Choice Medicaid |
$141.65
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$141.65
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$304.55
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$304.55
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$141.65
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$148.73
|
|
|
EAPG 851: POISONING OF MEDICINAL AGENTS
|
Facility
OP
|
$367.02
|
|
|
Service Code
|
EAPG 0851
|
| Min. Negotiated Rate |
$163.12 |
| Max. Negotiated Rate |
$367.02 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$367.02
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$163.12
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$163.12
|
| Rate for Payer: CDPHP Essential Plan |
$367.02
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$195.74
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$163.12
|
| Rate for Payer: EmblemHealth Medicaid |
$163.12
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$367.02
|
| Rate for Payer: Hamaspik Choice Medicaid |
$163.12
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$163.12
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$350.71
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$350.71
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$163.12
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$171.28
|
|
|
EAPG 852: OTHER COMPLICATIONS OF TREATMENT
|
Facility
OP
|
$315.07
|
|
|
Service Code
|
EAPG 0852
|
| Min. Negotiated Rate |
$140.03 |
| Max. Negotiated Rate |
$315.07 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$315.07
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$140.03
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$140.03
|
| Rate for Payer: CDPHP Essential Plan |
$315.07
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$168.04
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$140.03
|
| Rate for Payer: EmblemHealth Medicaid |
$140.03
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$315.07
|
| Rate for Payer: Hamaspik Choice Medicaid |
$140.03
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$140.03
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$301.06
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$301.06
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$140.03
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$147.03
|
|
|
EAPG 853: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES
|
Facility
OP
|
$329.29
|
|
|
Service Code
|
EAPG 0853
|
| Min. Negotiated Rate |
$146.35 |
| Max. Negotiated Rate |
$329.29 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$329.29
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$146.35
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$146.35
|
| Rate for Payer: CDPHP Essential Plan |
$329.29
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$175.62
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$146.35
|
| Rate for Payer: EmblemHealth Medicaid |
$146.35
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$329.29
|
| Rate for Payer: Hamaspik Choice Medicaid |
$146.35
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$146.35
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$314.65
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$314.65
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$146.35
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$153.67
|
|
|
EAPG 854: TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES
|
Facility
OP
|
$286.20
|
|
|
Service Code
|
EAPG 0854
|
| Min. Negotiated Rate |
$127.20 |
| Max. Negotiated Rate |
$286.20 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$286.20
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$127.20
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$127.20
|
| Rate for Payer: CDPHP Essential Plan |
$286.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$152.64
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$127.20
|
| Rate for Payer: EmblemHealth Medicaid |
$127.20
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$286.20
|
| Rate for Payer: Hamaspik Choice Medicaid |
$127.20
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$127.20
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$273.48
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$273.48
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$127.20
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$133.56
|
|
