|
PSYCHOTHERAPY 60 MINUTES
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84504045
|
|
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 |
$141.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$118.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY 60 MINUTES
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
87506035
|
|
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 |
$141.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$118.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY 60 MINUTES
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
87504040
|
|
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 |
$141.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$118.22
|
| 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 |
87506035
|
|
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
|
OP
|
$1,017.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
94810175
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$118.22 |
| Max. Negotiated Rate |
$305.10 |
| Rate for Payer: Aetna Commercial |
$305.10
|
| Rate for Payer: Aetna Medicare Advantage |
$305.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$259.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$259.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$141.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$259.33
|
| Rate for Payer: Cigna Commercial |
$118.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$152.55
|
|
|
PSYCHOTHERAPY 60 MINUTES
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84504045
|
|
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 ADD E
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84517015
|
|
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 |
$141.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$118.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY 60 MINUTES ADD E
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84511015
|
|
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 ADD E
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84518015
|
|
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 |
$141.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$118.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY 60 MINUTES ADD E
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84517015
|
|
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 ADD E
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84518015
|
|
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 ADD E
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84509015
|
|
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 ADD E
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84509015
|
|
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 |
$141.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$118.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY 60 MINUTES ADD E
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90838
|
| Hospital Charge Code |
84511015
|
|
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 |
$141.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$118.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY CRISIS 1ST 60MIN
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90839
|
| Hospital Charge Code |
83246175
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY CRISIS 1ST 60MIN
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90839
|
| Hospital Charge Code |
83246175
|
|
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 |
$139.23
|
| 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 CRISIS ADD 30MIN
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90840
|
| Hospital Charge Code |
83246180
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$66.85 |
| 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) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$66.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY CRISIS ADD 30MIN
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90840
|
| Hospital Charge Code |
83246180
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY NON-MD 60 MINS
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
84517013
|
|
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 NON-MD 60 MINS
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
87504035
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY NON-MD 60 MINS
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
84518013
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY NON-MD 60 MINS
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
84517013
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY NON-MD 60 MINS
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
84509013
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCHOTHERAPY NON-MD 60 MINS
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
84511013
|
|
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 NON-MD 60 MINS
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
84511013
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
