|
99291 Facility Level Critical Care Ill/Injured Patient Init 30-74 Min
|
Facility
|
OP
|
$7,640.00
|
|
|
Service Code
|
HCPCS 99291
|
| Hospital Charge Code |
2389455
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$520.00 |
| Max. Negotiated Rate |
$7,410.80 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$3,820.00
|
| Rate for Payer: Cash Price |
$4,966.00
|
| Rate for Payer: Cash Price |
$4,966.00
|
| Rate for Payer: Cash Price |
$4,966.00
|
| Rate for Payer: Devoted Health Medicare |
$4,202.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$588.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3,820.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$520.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$7,258.00
|
| Rate for Payer: Health Management Network Commercial |
$6,494.00
|
| Rate for Payer: Humana Medicare |
$3,820.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,876.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,820.00
|
| Rate for Payer: MDX Hawaii PPO |
$7,410.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,820.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,820.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,820.00
|
| Rate for Payer: University Health Alliance Commercial |
$5,568.80
|
|
|
99291 Facility Level Critical Care Ill/Injured Patient Init 30-74 Min
|
Facility
|
IP
|
$7,640.00
|
|
|
Service Code
|
HCPCS 99291
|
| Hospital Charge Code |
2389455
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,494.00 |
| Max. Negotiated Rate |
$7,410.80 |
| Rate for Payer: Cash Price |
$4,966.00
|
| Rate for Payer: Health Management Network Commercial |
$6,494.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,876.00
|
| Rate for Payer: MDX Hawaii PPO |
$7,410.80
|
|
|
99292 Critical Care, Each Additional 30 Min
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 99292
|
| Hospital Charge Code |
8041057
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$99.35 |
| Max. Negotiated Rate |
$318.75 |
| Rate for Payer: AlohaCare Medicaid |
$105.97
|
| Rate for Payer: AlohaCare Medicare |
$99.35
|
| Rate for Payer: Cash Price |
$243.75
|
| Rate for Payer: Cash Price |
$243.75
|
| Rate for Payer: Devoted Health Medicare |
$109.28
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$105.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$99.35
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$105.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$117.90
|
| Rate for Payer: Health Management Network Commercial |
$318.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$109.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$99.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$99.35
|
|
|
99292 ED Critical Care, E/M each additional 30 min over 74 minutes
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 99292
|
| Hospital Charge Code |
8749414
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$99.35 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: AlohaCare Medicaid |
$105.97
|
| Rate for Payer: AlohaCare Medicare |
$99.35
|
| Rate for Payer: Cash Price |
$154.70
|
| Rate for Payer: Cash Price |
$154.70
|
| Rate for Payer: Devoted Health Medicare |
$109.28
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$105.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$99.35
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$105.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$117.90
|
| Rate for Payer: Health Management Network Commercial |
$202.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$109.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$99.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$99.35
|
|
|
99304 Initial Nursing Facility Care, Low
|
Professional
|
Both
|
$294.00
|
|
|
Service Code
|
HCPCS 99304
|
| Hospital Charge Code |
8041058
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$72.35 |
| Max. Negotiated Rate |
$249.90 |
| Rate for Payer: AlohaCare Medicaid |
$81.82
|
| Rate for Payer: AlohaCare Medicare |
$72.35
|
| Rate for Payer: Cash Price |
$191.10
|
| Rate for Payer: Cash Price |
$191.10
|
| Rate for Payer: Devoted Health Medicare |
$79.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$72.35
|
| Rate for Payer: Health Management Network Commercial |
$249.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$79.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$79.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$79.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$81.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$72.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$81.82
|
| Rate for Payer: UnitedHealthcare Medicare |
$72.35
|
|
|
99305 Initial Nursing Facility Care, Moderate
|
Professional
|
Both
|
$451.00
|
|
|
Service Code
|
HCPCS 99305
|
| Hospital Charge Code |
8041059
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$76.02 |
| Max. Negotiated Rate |
$383.35 |
| Rate for Payer: AlohaCare Medicaid |
$136.11
|
| Rate for Payer: AlohaCare Medicare |
$121.54
|
| Rate for Payer: Cash Price |
$293.15
|
| Rate for Payer: Cash Price |
$293.15
|
| Rate for Payer: Devoted Health Medicare |
$133.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$121.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$76.02
|
| Rate for Payer: Health Management Network Commercial |
$383.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$133.69
|
| Rate for Payer: Kaiser Permanente Medicaid |
$133.69
|
| Rate for Payer: Kaiser Permanente Medicare |
$133.69
|
| Rate for Payer: Ohana Health Plan Medicaid |
$136.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$121.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$136.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$121.54
|
|
|
99306 Initial Nursing Facility Care, High
|
Professional
|
Both
|
$439.00
|
|
|
Service Code
|
HCPCS 99306
|
| Hospital Charge Code |
8228786
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$373.15 |
| Rate for Payer: AlohaCare Medicaid |
$185.44
|
| Rate for Payer: AlohaCare Medicare |
$165.40
|
| Rate for Payer: Cash Price |
$285.35
|
| Rate for Payer: Cash Price |
$285.35
|
| Rate for Payer: Devoted Health Medicare |
$181.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$83.07
|
| Rate for Payer: Health Management Network Commercial |
$373.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$181.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$185.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$185.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.40
|
|
|
99306 Initial Nursing Facility Care, High
|
Professional
|
Both
|
$571.00
|
|
|
Service Code
|
HCPCS 99306
|
| Hospital Charge Code |
8041060
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$485.35 |
| Rate for Payer: AlohaCare Medicaid |
$185.44
|
| Rate for Payer: AlohaCare Medicare |
$165.40
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Devoted Health Medicare |
$181.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$83.07
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$181.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$185.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$185.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.40
|
|
|
99307 A - NURSING FACILITY SUBSEQUENT LEVEL 1 OF 4
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 99307
|
| Hospital Charge Code |
10101289
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: AlohaCare Medicaid |
$41.45
|
| Rate for Payer: AlohaCare Medicare |
$38.02
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Devoted Health Medicare |
$41.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$27.59
|
| Rate for Payer: Health Management Network Commercial |
$76.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$41.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$41.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$41.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$41.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.02
|
|
|
99307 B - NURSING FACILITY SUBSEQUENT LEVEL 1 OF 4
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 99307
|
| Hospital Charge Code |
10101290
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: AlohaCare Medicaid |
$41.45
|
| Rate for Payer: AlohaCare Medicare |
$38.02
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Devoted Health Medicare |
$41.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$27.59
|
| Rate for Payer: Health Management Network Commercial |
$76.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$41.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$41.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$41.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$41.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.02
|
|
|
99307 Subsequent Nursing Facility Care, Straightforward
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 99307
|
| Hospital Charge Code |
8041061
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$131.75 |
| Rate for Payer: AlohaCare Medicaid |
$41.45
|
| Rate for Payer: AlohaCare Medicare |
$38.02
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Devoted Health Medicare |
$41.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$27.59
|
| Rate for Payer: Health Management Network Commercial |
$131.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$41.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$41.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$41.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$41.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.02
|
|
|
99308 Subsequent Nursing Facility Care, Low
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 99308
|
| Hospital Charge Code |
8041062
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$50.97 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: AlohaCare Medicaid |
$76.70
|
| Rate for Payer: AlohaCare Medicare |
$69.65
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Devoted Health Medicare |
$76.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$50.97
|
| Rate for Payer: Health Management Network Commercial |
$204.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$76.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$76.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$76.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$76.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.65
|
| Rate for Payer: UnitedHealthcare Medicaid |
$76.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.65
|
|
|
99309 Subsequent Nursing Facility Care, Moderate
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 99309
|
| Hospital Charge Code |
8041063
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$69.47 |
| Max. Negotiated Rate |
$268.60 |
| Rate for Payer: AlohaCare Medicaid |
$110.71
|
| Rate for Payer: AlohaCare Medicare |
$100.64
|
| Rate for Payer: Cash Price |
$205.40
|
| Rate for Payer: Cash Price |
$205.40
|
| Rate for Payer: Devoted Health Medicare |
$110.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$100.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$69.47
|
| Rate for Payer: Health Management Network Commercial |
$268.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$110.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$110.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$110.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$110.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$100.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$110.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$100.64
|
|
|
99310 Subsequent Nursing Facility Care, High
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
HCPCS 99310
|
| Hospital Charge Code |
8041064
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$111.74 |
| Max. Negotiated Rate |
$395.25 |
| Rate for Payer: AlohaCare Medicaid |
$157.37
|
| Rate for Payer: AlohaCare Medicare |
$142.78
|
| Rate for Payer: Cash Price |
$302.25
|
| Rate for Payer: Cash Price |
$302.25
|
| Rate for Payer: Devoted Health Medicare |
$157.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$142.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$111.74
|
| Rate for Payer: Health Management Network Commercial |
$395.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$157.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$157.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$157.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$157.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$142.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$157.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$142.78
|
|
|
99315 Nursing Facility Discharge, < 30 Min
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS 99315
|
| Hospital Charge Code |
8041065
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$45.97 |
| Max. Negotiated Rate |
$192.10 |
| Rate for Payer: AlohaCare Medicaid |
$83.54
|
| Rate for Payer: AlohaCare Medicare |
$74.63
|
| Rate for Payer: Cash Price |
$146.90
|
| Rate for Payer: Cash Price |
$146.90
|
| Rate for Payer: Devoted Health Medicare |
$82.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$74.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$45.97
|
| Rate for Payer: Health Management Network Commercial |
$192.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$82.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$82.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$82.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$83.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$83.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$74.63
|
|
|
99316 Nursing Facility Discharge, 31+ Min
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 99316
|
| Hospital Charge Code |
8041066
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$73.13 |
| Max. Negotiated Rate |
$250.75 |
| Rate for Payer: AlohaCare Medicaid |
$133.44
|
| Rate for Payer: AlohaCare Medicare |
$119.07
|
| Rate for Payer: Cash Price |
$191.75
|
| Rate for Payer: Cash Price |
$191.75
|
| Rate for Payer: Devoted Health Medicare |
$130.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$119.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.13
|
| Rate for Payer: Health Management Network Commercial |
$250.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$130.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$130.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$130.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$119.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$133.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$119.07
|
|
|
99318 Annual Nursing Facility Assessment
|
Professional
|
Both
|
$330.00
|
|
| Hospital Charge Code |
8041067
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$280.50 |
| Max. Negotiated Rate |
$280.50 |
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Health Management Network Commercial |
$280.50
|
|
|
99360 PHYS STANDBY REQ'D 30M EA ProFee
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 99360
|
| Hospital Charge Code |
8022475
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$76.50 |
| Max. Negotiated Rate |
$86.17 |
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$86.17
|
| Rate for Payer: Health Management Network Commercial |
$76.50
|
|
|
99406 SMOKING CESSATION COUNSELING 3 - 10 MIN CHARGE
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS 99406
|
| Hospital Charge Code |
8045931
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$155.20 |
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Health Management Network Commercial |
$136.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$144.00
|
| Rate for Payer: MDX Hawaii PPO |
$155.20
|
|
|
99406 SMOKING CESSATION COUNSELING 3 - 10 MIN CHARGE
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS 99406
|
| Hospital Charge Code |
8045931
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$9.63 |
| Max. Negotiated Rate |
$155.20 |
| Rate for Payer: AlohaCare Medicaid |
$80.00
|
| Rate for Payer: AlohaCare Medicare |
$80.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Devoted Health Medicare |
$88.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$47.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$80.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.00
|
| Rate for Payer: Health Management Network Commercial |
$136.00
|
| Rate for Payer: Humana Medicare |
$80.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$144.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$81.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$80.00
|
| Rate for Payer: MDX Hawaii PPO |
$155.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$80.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$80.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.63
|
| Rate for Payer: UnitedHealthcare Medicare |
$80.00
|
| Rate for Payer: University Health Alliance Commercial |
$116.62
|
|
|
99407 SMOKING CESSATION COUNSELING >10 MIN CHARGE
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS 99407
|
| Hospital Charge Code |
8045932
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$19.82 |
| Max. Negotiated Rate |
$155.20 |
| Rate for Payer: AlohaCare Medicaid |
$80.00
|
| Rate for Payer: AlohaCare Medicare |
$80.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Devoted Health Medicare |
$88.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$47.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$80.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.00
|
| Rate for Payer: Health Management Network Commercial |
$136.00
|
| Rate for Payer: Humana Medicare |
$80.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$144.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$81.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$80.00
|
| Rate for Payer: MDX Hawaii PPO |
$155.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$80.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$80.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$19.82
|
| Rate for Payer: UnitedHealthcare Medicare |
$80.00
|
| Rate for Payer: University Health Alliance Commercial |
$116.62
|
|
|
99407 SMOKING CESSATION COUNSELING >10 MIN CHARGE
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS 99407
|
| Hospital Charge Code |
8045932
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$155.20 |
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Health Management Network Commercial |
$136.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$144.00
|
| Rate for Payer: MDX Hawaii PPO |
$155.20
|
|
|
99417-Prolonged office or other outpatient evaluation and management service(s)
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 99417
|
| Hospital Charge Code |
9338509
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$30.23 |
| Max. Negotiated Rate |
$67.15 |
| Rate for Payer: Cash Price |
$51.35
|
| Rate for Payer: Cash Price |
$51.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$30.23
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$30.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.64
|
| Rate for Payer: Health Management Network Commercial |
$67.15
|
|
|
99417 Prolonged Office/Outpatient E/M Svc Ea 15 Min
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 99417
|
| Hospital Charge Code |
9350613
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$30.23 |
| Max. Negotiated Rate |
$67.15 |
| Rate for Payer: Cash Price |
$51.35
|
| Rate for Payer: Cash Price |
$51.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$30.23
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$30.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.64
|
| Rate for Payer: Health Management Network Commercial |
$67.15
|
|
|
99418 Prolonged Inpt/Obs E/M time with or w/o Direct Pt Contact
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 99418
|
| Hospital Charge Code |
10599938
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$207.40 |
| Max. Negotiated Rate |
$207.40 |
| Rate for Payer: Cash Price |
$158.60
|
| Rate for Payer: Health Management Network Commercial |
$207.40
|
|
