|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$97.62
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$16.46 |
| Max. Negotiated Rate |
$52.92 |
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$23.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.64
|
| Rate for Payer: Healthfirst Commercial |
$23.52
|
| Rate for Payer: Healthfirst Essential Plan |
$52.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.34
|
| Rate for Payer: Healthfirst QHP |
$23.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$23.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$19.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17.64
|
| Rate for Payer: SOMOS Essential |
$17.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23.52
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$106.26
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$260.71 |
| Rate for Payer: Amida Care Medicaid |
$15.40
|
| Rate for Payer: Cash Price |
$118.48
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$115.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$104.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$104.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$110.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$115.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$110.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$115.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$115.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$86.90
|
| Rate for Payer: Healthfirst Commercial |
$115.87
|
| Rate for Payer: Healthfirst Essential Plan |
$260.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$110.08
|
| Rate for Payer: Healthfirst QHP |
$115.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$81.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$115.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$98.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$81.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$115.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$86.90
|
| Rate for Payer: SOMOS Essential |
$86.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$115.87
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Professional
|
Both
|
$214.06
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$36.30 |
| Max. Negotiated Rate |
$116.66 |
| Rate for Payer: Amida Care Medicaid |
$43.66
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$51.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$46.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$46.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$49.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$51.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$49.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38.89
|
| Rate for Payer: Healthfirst Commercial |
$51.85
|
| Rate for Payer: Healthfirst Essential Plan |
$116.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$49.26
|
| Rate for Payer: Healthfirst QHP |
$51.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$36.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$51.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$44.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$36.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$51.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$38.89
|
| Rate for Payer: SOMOS Essential |
$38.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$51.85
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$84.53
|
|
|
Service Code
|
HCPCS 99453
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Amida Care Medicaid |
$15.00
|
| Rate for Payer: Cash Price |
$24.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$24.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.11
|
| Rate for Payer: Healthfirst Commercial |
$24.14
|
| Rate for Payer: Healthfirst Essential Plan |
$54.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.93
|
| Rate for Payer: Healthfirst QHP |
$24.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.90
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$24.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$20.52
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18.11
|
| Rate for Payer: SOMOS Essential |
$18.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24.14
|
|
|
PR REMOTE E/M EST. PT 10MINS
|
Professional
|
Both
|
$76.55
|
|
|
Service Code
|
HCPCS G9486
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$44.17 |
| Rate for Payer: Cash Price |
$20.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.72
|
| Rate for Payer: Healthfirst Commercial |
$19.63
|
| Rate for Payer: Healthfirst Essential Plan |
$44.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.65
|
| Rate for Payer: Healthfirst QHP |
$19.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$19.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$16.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$14.72
|
| Rate for Payer: SOMOS Essential |
$14.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.63
|
|
|
PR REMOTE E/M EST. PT 10MINS
|
Professional
|
Both
|
$118.23
|
|
|
Service Code
|
HCPCS G9983
|
| Min. Negotiated Rate |
$21.89 |
| Max. Negotiated Rate |
$70.36 |
| Rate for Payer: Cash Price |
$31.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$31.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$28.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$31.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.45
|
| Rate for Payer: Healthfirst Commercial |
$31.27
|
| Rate for Payer: Healthfirst Essential Plan |
$70.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.71
|
| Rate for Payer: Healthfirst QHP |
$31.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.89
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$31.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23.45
|
| Rate for Payer: SOMOS Essential |
$23.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31.27
|
|
|
PR REMOTE E/M EST. PT 15MINS
|
Professional
|
Both
|
$227.92
|
|
|
Service Code
|
HCPCS G9984
|
| Min. Negotiated Rate |
$43.20 |
| Max. Negotiated Rate |
$138.87 |
| Rate for Payer: Cash Price |
$62.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$61.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$55.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$55.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$58.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$61.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$58.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$61.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$61.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$46.29
|
| Rate for Payer: Healthfirst Commercial |
$61.72
|
| Rate for Payer: Healthfirst Essential Plan |
$138.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$58.63
|
| Rate for Payer: Healthfirst QHP |
$61.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$43.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$61.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$52.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$43.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$61.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$46.29
|
| Rate for Payer: SOMOS Essential |
$46.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$61.72
|
|
|
PR REMOTE E/M EST. PT 15MINS
|
Professional
|
Both
|
$148.86
|
|
|
Service Code
|
HCPCS G9487
|
| Min. Negotiated Rate |
$27.72 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Cash Price |
$40.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$39.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$35.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$37.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$39.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.70
|
| Rate for Payer: Healthfirst Commercial |
$39.60
|
| Rate for Payer: Healthfirst Essential Plan |
$89.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$37.62
|
| Rate for Payer: Healthfirst QHP |
$39.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$27.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$39.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$33.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$27.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$39.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$29.70
|
| Rate for Payer: SOMOS Essential |
$29.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.60
|
|
|
PR REMOTE E/M EST. PT 25MINS
|
Professional
|
Both
|
$226.17
|
|
|
Service Code
|
HCPCS G9488
|
| Min. Negotiated Rate |
$42.66 |
| Max. Negotiated Rate |
$137.14 |
| Rate for Payer: Cash Price |
$61.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$60.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$54.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$54.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$57.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$60.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$57.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$60.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$60.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$45.71
|
| Rate for Payer: Healthfirst Commercial |
$60.95
|
| Rate for Payer: Healthfirst Essential Plan |
$137.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$57.90
|
| Rate for Payer: Healthfirst QHP |
$60.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$42.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$60.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$51.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$42.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$60.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$45.71
|
| Rate for Payer: SOMOS Essential |
$45.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$60.95
|
|
|
PR REMOTE E/M EST. PT 25MINS
|
Professional
|
Both
|
$344.05
|
|
|
Service Code
|
HCPCS G9985
|
| Min. Negotiated Rate |
$65.21 |
| Max. Negotiated Rate |
$209.61 |
| Rate for Payer: Cash Price |
$93.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$93.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$83.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$83.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$88.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$93.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$88.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$93.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$93.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$69.87
|
| Rate for Payer: Healthfirst Commercial |
$93.16
|
| Rate for Payer: Healthfirst Essential Plan |
$209.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$88.50
|
| Rate for Payer: Healthfirst QHP |
$93.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$65.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$93.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$79.19
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$65.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$93.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$69.87
|
| Rate for Payer: SOMOS Essential |
$69.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$93.16
|
|
|
PR REMOTE E/M EST. PT 40MINS
|
Professional
|
Both
|
$318.99
|
|
|
Service Code
|
HCPCS G9489
|
| Min. Negotiated Rate |
$59.97 |
| Max. Negotiated Rate |
$192.76 |
| Rate for Payer: Cash Price |
$87.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$85.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$77.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$77.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$81.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$85.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$81.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$85.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$85.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$64.25
|
| Rate for Payer: Healthfirst Commercial |
$85.67
|
| Rate for Payer: Healthfirst Essential Plan |
$192.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$81.39
|
| Rate for Payer: Healthfirst QHP |
$85.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$59.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$85.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$72.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$59.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$85.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$64.25
|
| Rate for Payer: SOMOS Essential |
$64.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$85.67
|
|
|
PR REMOTE E/M EST. PT 40MINS
|
Professional
|
Both
|
$495.81
|
|
|
Service Code
|
HCPCS G9986
|
| Min. Negotiated Rate |
$94.75 |
| Max. Negotiated Rate |
$304.54 |
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$135.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$121.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$121.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$128.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$135.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$128.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$135.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$135.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$101.51
|
| Rate for Payer: Healthfirst Commercial |
$135.35
|
| Rate for Payer: Healthfirst Essential Plan |
$304.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$128.58
|
| Rate for Payer: Healthfirst QHP |
$135.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$94.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$135.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$115.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$94.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$135.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$101.51
|
| Rate for Payer: SOMOS Essential |
$101.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$135.35
|
|
|
PR REMOTE E/M NEW PT 10MINS
|
Professional
|
Both
|
$76.55
|
|
|
Service Code
|
HCPCS G9481
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$44.17 |
| Rate for Payer: Cash Price |
$20.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.72
|
| Rate for Payer: Healthfirst Commercial |
$19.63
|
| Rate for Payer: Healthfirst Essential Plan |
$44.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.65
|
| Rate for Payer: Healthfirst QHP |
$19.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$19.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$16.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$14.72
|
| Rate for Payer: SOMOS Essential |
$14.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.63
|
|
|
PR REMOTE E/M NEW PT 10MINS
|
Professional
|
Both
|
$118.23
|
|
|
Service Code
|
HCPCS G9978
|
| Min. Negotiated Rate |
$21.89 |
| Max. Negotiated Rate |
$70.36 |
| Rate for Payer: Cash Price |
$31.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$31.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$28.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$31.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.45
|
| Rate for Payer: Healthfirst Commercial |
$31.27
|
| Rate for Payer: Healthfirst Essential Plan |
$70.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.71
|
| Rate for Payer: Healthfirst QHP |
$31.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.89
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$31.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23.45
|
| Rate for Payer: SOMOS Essential |
$23.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31.27
|
|
|
PR REMOTE E/M NEW PT 20MINS
|
Professional
|
Both
|
$138.36
|
|
|
Service Code
|
HCPCS G9482
|
| Min. Negotiated Rate |
$25.45 |
| Max. Negotiated Rate |
$81.81 |
| Rate for Payer: Cash Price |
$37.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$36.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$36.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.27
|
| Rate for Payer: Healthfirst Commercial |
$36.36
|
| Rate for Payer: Healthfirst Essential Plan |
$81.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$34.54
|
| Rate for Payer: Healthfirst QHP |
$36.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.45
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$36.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$30.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27.27
|
| Rate for Payer: SOMOS Essential |
$27.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36.36
|
|
|
PR REMOTE E/M NEW PT 20MINS
|
Professional
|
Both
|
$197.30
|
|
|
Service Code
|
HCPCS G9979
|
| Min. Negotiated Rate |
$36.32 |
| Max. Negotiated Rate |
$116.75 |
| Rate for Payer: Cash Price |
$53.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$51.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$46.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$46.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$49.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$51.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$49.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38.92
|
| Rate for Payer: Healthfirst Commercial |
$51.89
|
| Rate for Payer: Healthfirst Essential Plan |
$116.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$49.30
|
| Rate for Payer: Healthfirst QHP |
$51.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$36.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$51.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$44.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$36.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$51.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$38.92
|
| Rate for Payer: SOMOS Essential |
$38.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$51.89
|
|
|
PR REMOTE E/M NEW PT 30 MINS
|
Professional
|
Both
|
$322.11
|
|
|
Service Code
|
HCPCS G9980
|
| Min. Negotiated Rate |
$59.91 |
| Max. Negotiated Rate |
$192.58 |
| Rate for Payer: Cash Price |
$86.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$85.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$77.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$77.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$81.31
|
| Rate for Payer: Fidelis Medicare Advantage |
$85.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$81.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$85.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$85.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$64.19
|
| Rate for Payer: Healthfirst Commercial |
$85.59
|
| Rate for Payer: Healthfirst Essential Plan |
$192.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$81.31
|
| Rate for Payer: Healthfirst QHP |
$85.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$59.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$85.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$72.75
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$59.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$85.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$64.19
|
| Rate for Payer: SOMOS Essential |
$64.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$85.59
|
|
|
PR REMOTE E/M NEW PT 30MINS
|
Professional
|
Both
|
$224.35
|
|
|
Service Code
|
HCPCS G9483
|
| Min. Negotiated Rate |
$41.17 |
| Max. Negotiated Rate |
$132.32 |
| Rate for Payer: Cash Price |
$59.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$58.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$52.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$52.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$55.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$58.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$55.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$58.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$58.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$44.11
|
| Rate for Payer: Healthfirst Commercial |
$58.81
|
| Rate for Payer: Healthfirst Essential Plan |
$132.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$55.87
|
| Rate for Payer: Healthfirst QHP |
$58.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$41.17
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$58.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$49.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$41.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$58.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$44.11
|
| Rate for Payer: SOMOS Essential |
$44.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$58.81
|
|
|
PR REMOTE E/M NEW PT 45MINS
|
Professional
|
Both
|
$367.29
|
|
|
Service Code
|
HCPCS G9484
|
| Min. Negotiated Rate |
$68.98 |
| Max. Negotiated Rate |
$221.74 |
| Rate for Payer: Cash Price |
$99.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$98.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$88.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$88.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$93.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$98.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$93.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$98.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$98.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$73.91
|
| Rate for Payer: Healthfirst Commercial |
$98.55
|
| Rate for Payer: Healthfirst Essential Plan |
$221.74
|
| Rate for Payer: Healthfirst Medicare Advantage |
$93.62
|
| Rate for Payer: Healthfirst QHP |
$98.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$68.98
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$98.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$83.77
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$68.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$98.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$73.91
|
| Rate for Payer: SOMOS Essential |
$73.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$98.55
|
|
|
PR REMOTE E/M NEW PT 45MINS
|
Professional
|
Both
|
$526.86
|
|
|
Service Code
|
HCPCS G9981
|
| Min. Negotiated Rate |
$100.23 |
| Max. Negotiated Rate |
$322.15 |
| Rate for Payer: Cash Price |
$144.16
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$143.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$128.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$128.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$136.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$143.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$136.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$143.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$143.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$107.39
|
| Rate for Payer: Healthfirst Commercial |
$143.18
|
| Rate for Payer: Healthfirst Essential Plan |
$322.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$136.02
|
| Rate for Payer: Healthfirst QHP |
$143.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$100.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$143.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$121.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$100.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$143.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$107.39
|
| Rate for Payer: SOMOS Essential |
$107.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$143.18
|
|
|
PR REMOTE E/M NEW PT 60MINS
|
Professional
|
Both
|
$703.22
|
|
|
Service Code
|
HCPCS G9982
|
| Min. Negotiated Rate |
$134.36 |
| Max. Negotiated Rate |
$431.87 |
| Rate for Payer: Cash Price |
$192.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$191.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$172.75
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$172.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$182.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$191.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$182.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$191.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$191.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$143.96
|
| Rate for Payer: Healthfirst Commercial |
$191.94
|
| Rate for Payer: Healthfirst Essential Plan |
$431.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$182.34
|
| Rate for Payer: Healthfirst QHP |
$191.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$134.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$191.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$163.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$134.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$191.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$143.96
|
| Rate for Payer: SOMOS Essential |
$143.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$191.94
|
|
|
PR REMOTE E/M NEW PT 60MINS
|
Professional
|
Both
|
$481.85
|
|
|
Service Code
|
HCPCS G9485
|
| Min. Negotiated Rate |
$91.15 |
| Max. Negotiated Rate |
$293.00 |
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$130.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$117.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$117.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$123.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$130.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$123.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$130.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$130.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$97.67
|
| Rate for Payer: Healthfirst Commercial |
$130.22
|
| Rate for Payer: Healthfirst Essential Plan |
$293.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$123.71
|
| Rate for Payer: Healthfirst QHP |
$130.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$91.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$130.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$110.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$91.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$130.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$97.67
|
| Rate for Payer: SOMOS Essential |
$97.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$130.22
|
|
|
PR REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D
|
Professional
|
Both
|
$145.64
|
|
|
Service Code
|
HCPCS 93264
|
| Min. Negotiated Rate |
$27.52 |
| Max. Negotiated Rate |
$88.45 |
| Rate for Payer: Cash Price |
$40.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$39.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$35.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$37.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$39.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.48
|
| Rate for Payer: Healthfirst Commercial |
$39.31
|
| Rate for Payer: Healthfirst Essential Plan |
$88.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$37.34
|
| Rate for Payer: Healthfirst QHP |
$39.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$27.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$39.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$33.41
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$27.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$39.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$29.48
|
| Rate for Payer: SOMOS Essential |
$29.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.31
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH
|
Professional
|
Both
|
$121.84
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$32.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.60
|
| Rate for Payer: Healthfirst Commercial |
$32.80
|
| Rate for Payer: Healthfirst Essential Plan |
$73.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31.16
|
| Rate for Payer: Healthfirst QHP |
$32.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$22.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$32.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$27.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$22.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.60
|
| Rate for Payer: SOMOS Essential |
$24.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32.80
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO
|
Professional
|
Both
|
$121.84
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$32.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.60
|
| Rate for Payer: Healthfirst Commercial |
$32.80
|
| Rate for Payer: Healthfirst Essential Plan |
$73.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31.16
|
| Rate for Payer: Healthfirst QHP |
$32.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$22.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$32.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$27.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$22.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.60
|
| Rate for Payer: SOMOS Essential |
$24.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32.80
|
|
