|
PSYCH DIAGNOSTIC EVAL
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
84310001
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCH DIAGNOSTIC EVAL
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
84310001
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$15.62 |
| Max. Negotiated Rate |
$3,080.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$246.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.00
|
| Rate for Payer: Oxford Commercial |
$2,715.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,080.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$171.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.62
|
|
|
PSYCH DIAGNOSTIC EVAL MD
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
83246145
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$15.62 |
| Max. Negotiated Rate |
$3,080.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$612.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.00
|
| Rate for Payer: Oxford Commercial |
$2,715.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,080.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.62
|
|
|
PSYCH DIAGNOSTIC EVAL MD
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
83246145
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
PSYCH DIAGNOSTIC EVAL NON MD
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
83246140
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSYCH DIAGNOSTIC EVAL NON MD
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
83246140
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$3,080.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$246.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,768.00
|
| Rate for Payer: Oxford Commercial |
$2,715.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,080.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$214.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$171.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$193.12
|
|
|
PSYCH DIAGNOSTIC EVALUATION
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
7500129
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$3,080.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$246.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,768.00
|
| Rate for Payer: Oxford Commercial |
$2,715.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,080.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$214.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$171.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$193.12
|
|
|
PSYCH DIAGNOSTIC EVALUATION
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
7500129
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSYCH DX INTERVIEW W/SOC WRKR
|
Facility
|
OP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
7500050
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$3,080.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$246.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,768.00
|
| Rate for Payer: Oxford Commercial |
$2,715.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,080.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$214.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$171.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$193.12
|
|
|
PSYCH DX INTERVIEW W/SOC WRKR
|
Facility
|
IP
|
$6,800.00
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
7500050
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,020.00
|
|
|
PSYCH DYFS CLUBHOUSE GROUP
|
Facility
|
OP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
84310115
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.74
|
|
|
PSYCH DYFS CLUBHOUSE GROUP
|
Facility
|
IP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
84310115
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
|
PSYCH-ED GROUP ADL
|
Facility
|
OP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246050
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.74
|
|
|
PSYCH-ED GROUP ADL
|
Facility
|
IP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246050
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
|
PSYCH-ED GROUP ANGER/ANXIETY/F
|
Facility
|
OP
|
$800.80
|
|
| Hospital Charge Code |
24846085
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$400.40 |
| Rate for Payer: Aetna Commercial |
$304.30
|
| Rate for Payer: Aetna Medicare Advantage |
$240.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.20
|
| Rate for Payer: Cigna Commercial |
$400.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.74
|
|
|
PSYCH-ED GROUP ANGER/ANXIETY/F
|
Facility
|
IP
|
$800.80
|
|
| Hospital Charge Code |
24746085
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
|
PSYCH-ED GROUP ANGER/ANXIETY/F
|
Facility
|
IP
|
$800.80
|
|
| Hospital Charge Code |
24846085
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
|
PSYCH-ED GROUP ANGER/ANXIETY/F
|
Facility
|
OP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246085
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.74
|
|
|
PSYCH-ED GROUP ANGER/ANXIETY/F
|
Facility
|
OP
|
$800.80
|
|
| Hospital Charge Code |
24746085
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$400.40 |
| Rate for Payer: Aetna Commercial |
$304.30
|
| Rate for Payer: Aetna Medicare Advantage |
$240.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.20
|
| Rate for Payer: Cigna Commercial |
$400.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.74
|
|
|
PSYCH-ED GROUP ANGER/ANXIETY/F
|
Facility
|
IP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246085
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
|
PSYCH-ED GROUP-ASSERTIVE BEHAV
|
Facility
|
OP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246035
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.74
|
|
|
PSYCH-ED GROUP-ASSERTIVE BEHAV
|
Facility
|
IP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246035
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
|
PSYCH-ED GROUP DEPRESSION/SADN
|
Facility
|
OP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246045
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.74
|
|
|
PSYCH-ED GROUP DEPRESSION/SADN
|
Facility
|
IP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246045
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
|
PSYCH-ED GROUP DISCHARGE PLAN
|
Facility
|
IP
|
$800.80
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83246090
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
