|
PSYCHOTHERAPY 30 MINUTES
|
Facility
|
OP
|
$183.00
|
|
|
Service Code
|
HCPCS 90832
|
| Hospital Charge Code |
94810165
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$23.79 |
| Max. Negotiated Rate |
$422.69 |
| Rate for Payer: Aetna Commercial |
$54.90
|
| Rate for Payer: Aetna Medicare Advantage |
$54.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.66
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.45
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$71.39
|
|
|
PSYCHOTHERAPY 30 MINUTES
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
HCPCS 90833
|
| Hospital Charge Code |
84504035
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$44.25 |
| Max. Negotiated Rate |
$44.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.25
|
|
|
PSYCHOTHERAPY 30 MINUTES
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
HCPCS 90833
|
| Hospital Charge Code |
84504035
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$38.35 |
| Max. Negotiated Rate |
$122.43 |
| Rate for Payer: Aetna Commercial |
$88.50
|
| Rate for Payer: Aetna Medicare Advantage |
$88.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$122.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.22
|
| Rate for Payer: Cigna Commercial |
$70.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.25
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$73.61
|
|
|
PSYCHOTHERAPY, 45 MIN (38-52)
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
83246160
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY, 45 MIN (38-52)
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
83246160
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$422.69 |
| Rate for Payer: Aetna Commercial |
$165.00
|
| Rate for Payer: Aetna Medicare Advantage |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
OP
|
$1,296.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
94810170
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$94.46 |
| Max. Negotiated Rate |
$422.69 |
| Rate for Payer: Aetna Commercial |
$388.80
|
| Rate for Payer: Aetna Medicare Advantage |
$388.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$330.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$330.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$330.48
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$168.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.40
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
87504030
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Aetna Commercial |
$165.00
|
| Rate for Payer: Aetna Medicare Advantage |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$89.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
IP
|
$1,296.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
94810170
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$194.40 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.40
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
87504030
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84504040
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84504040
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$147.87 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$89.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
87506030
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$147.87 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$89.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
87506030
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84518011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84518011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$147.87 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$89.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84517011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84517011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$147.87 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$89.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84511011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84511011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$147.87 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$89.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84509011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84509011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$147.87 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$89.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
|
|
PSYCHOTHERAPY, 60 MIN (53+)
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
83246165
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY, 60 MIN (53+)
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
83246165
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$422.69 |
| Rate for Payer: Aetna Commercial |
$165.00
|
| Rate for Payer: Aetna Medicare Advantage |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$135.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY 60 MINUTES
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
87504040
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY 60 MINUTES
|
Facility
|
IP
|
$1,017.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
94810175
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$152.55 |
| Max. Negotiated Rate |
$152.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$152.55
|
|
