|
PSYCHOTHERAPY 30 MINUTES
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
HCPCS 90833
|
| Hospital Charge Code |
84504035
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$147.50 |
| Rate for Payer: Aetna Commercial |
$112.10
|
| 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 |
$97.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.22
|
| Rate for Payer: Cigna Commercial |
$147.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.32
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$73.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.38
|
|
|
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 |
87506025
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$147.50 |
| Rate for Payer: Aetna Commercial |
$112.10
|
| 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 |
$97.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.22
|
| Rate for Payer: Cigna Commercial |
$147.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.32
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$73.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.38
|
|
|
PSYCHOTHERAPY 30 MINUTES
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
HCPCS 90833
|
| Hospital Charge Code |
87504020
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.50
|
|
|
PSYCHOTHERAPY 30 MINUTES
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
HCPCS 90833
|
| Hospital Charge Code |
87506025
|
|
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
|
$350.00
|
|
|
Service Code
|
HCPCS 90833
|
| Hospital Charge Code |
87504020
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna Commercial |
$133.00
|
| Rate for Payer: Aetna Medicare Advantage |
$105.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$97.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$89.25
|
| Rate for Payer: Cigna Commercial |
$175.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.06
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$73.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.94
|
|
|
PSYCHOTHERAPY, 45 MIN (38-52)
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
83246160
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$15.62 |
| Max. Negotiated Rate |
$764.93 |
| 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 |
$120.20
|
| 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: Qualcare PPO/HMO/WC |
$82.50
|
| 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 |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.62
|
|
|
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 MINUTES
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84504040
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| 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 |
$118.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
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
|
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
|
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
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
87504030
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$15.62 |
| Max. Negotiated Rate |
$275.00 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| 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 |
$118.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$275.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.38
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.62
|
|
|
PSYCHOTHERAPY 45 MINUTES
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
87506030
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| 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 |
$118.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
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 |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| 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 |
$118.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
PSYCHOTHERAPY 45 MINUTES ADD E
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90836
|
| Hospital Charge Code |
84517011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| 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 |
$118.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
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 |
84511011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| 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 |
$118.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
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
|
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 |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| 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 |
$118.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
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 |
$15.62 |
| Max. Negotiated Rate |
$764.93 |
| 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 |
$108.31
|
| 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: Qualcare PPO/HMO/WC |
$82.50
|
| 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: Wellpoint Medicaid Managed Care |
$15.62
|
|
|
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
|
|
