|
HOME HEALTH CARE SUPERVISION
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS G0181
|
| Hospital Charge Code |
51000153
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.45 |
| Max. Negotiated Rate |
$147.00 |
| Rate for Payer: Aetna Commercial |
$63.81
|
| Rate for Payer: Buckeye Medicare Advantage |
$147.00
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$146.70
|
| Rate for Payer: Multiplan PHCS |
$88.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$102.90
|
| Rate for Payer: UHCCP Medicaid |
$51.45
|
|
|
HOME HEALTH CARE SUPERVISION
|
Facility
|
OP
|
$147.00
|
|
|
Service Code
|
HCPCS G0181
|
| Hospital Charge Code |
51000153
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.11 |
| Max. Negotiated Rate |
$141.12 |
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: Anthem Medicaid |
$50.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$114.66
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Cigna Commercial |
$122.01
|
| Rate for Payer: First Health Commercial |
$139.65
|
| Rate for Payer: Humana Commercial |
$124.95
|
| Rate for Payer: Humana KY Medicaid |
$50.55
|
| Rate for Payer: Kentucky WC Medicaid |
$51.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$120.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$108.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$44.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$51.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$129.36
|
| Rate for Payer: Ohio Health Group HMO |
$110.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$45.57
|
| Rate for Payer: PHCS Commercial |
$141.12
|
| Rate for Payer: United Healthcare All Payer |
$129.36
|
|
|
HOME HEALTH CARE SUPERVISION
|
Facility
|
IP
|
$147.00
|
|
|
Service Code
|
HCPCS G0181
|
| Hospital Charge Code |
51000153
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.11 |
| Max. Negotiated Rate |
$141.12 |
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$114.66
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Cigna Commercial |
$122.01
|
| Rate for Payer: First Health Commercial |
$139.65
|
| Rate for Payer: Humana Commercial |
$124.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$120.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$108.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$44.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$129.36
|
| Rate for Payer: Ohio Health Group HMO |
$110.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$29.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19.11
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$45.57
|
| Rate for Payer: PHCS Commercial |
$141.12
|
| Rate for Payer: United Healthcare All Payer |
$129.36
|
|
|
HOME/RES VST NEW SF MDM 15
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 99341
|
| Hospital Charge Code |
51000337
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$85.42 |
| Rate for Payer: Aetna Commercial |
$85.42
|
| Rate for Payer: Anthem Medicaid |
$74.38
|
| Rate for Payer: Buckeye Medicare Advantage |
$70.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Cigna Commercial |
$82.47
|
| Rate for Payer: Healthspan PPO |
$66.17
|
| Rate for Payer: Humana Medicaid |
$74.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$74.72
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$75.87
|
| Rate for Payer: Molina Healthcare Passport |
$74.38
|
| Rate for Payer: Multiplan PHCS |
$42.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$49.00
|
| Rate for Payer: UHCCP Medicaid |
$24.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$75.12
|
|
|
HOME/RES VST NEW SF MDM 15(P
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 99341
|
| Hospital Charge Code |
510P0337
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$85.42 |
| Rate for Payer: Aetna Commercial |
$85.42
|
| Rate for Payer: Anthem Medicaid |
$74.38
|
| Rate for Payer: Buckeye Medicare Advantage |
$70.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Cigna Commercial |
$82.47
|
| Rate for Payer: Healthspan PPO |
$66.17
|
| Rate for Payer: Humana Medicaid |
$74.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$74.72
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$75.87
|
| Rate for Payer: Molina Healthcare Passport |
$74.38
|
| Rate for Payer: Multiplan PHCS |
$42.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$49.00
|
| Rate for Payer: UHCCP Medicaid |
$24.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$75.12
|
|
|
HOME SLEEP STUDY
|
Facility
|
IP
|
$1,905.00
|
|
|
Service Code
|
HCPCS 95806
|
| Hospital Charge Code |
92000013
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$247.65 |
| Max. Negotiated Rate |
$1,828.80 |
| Rate for Payer: Aetna Commercial |
$1,466.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,485.90
|
| Rate for Payer: Cash Price |
$952.50
|
| Rate for Payer: Cigna Commercial |
$1,581.15
|
| Rate for Payer: First Health Commercial |
$1,809.75
|
| Rate for Payer: Humana Commercial |
$1,619.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,562.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,405.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$571.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,676.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,428.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$381.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$247.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$590.55
|
| Rate for Payer: PHCS Commercial |
$1,828.80
|
| Rate for Payer: United Healthcare All Payer |
$1,676.40
|
|
|
HOME SLEEP STUDY
|
Facility
|
OP
|
$1,905.00
|
|
|
Service Code
|
HCPCS 95806
|
| Hospital Charge Code |
92000013
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$135.08 |
| Max. Negotiated Rate |
$1,828.80 |
| Rate for Payer: Aetna Commercial |
$1,466.85
|
| Rate for Payer: Anthem Medicaid |
$655.13
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$135.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,485.90
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$189.11
|
| Rate for Payer: CareSource Just4Me Medicare |
$182.36
|
| Rate for Payer: Cash Price |
$952.50
|
| Rate for Payer: Cash Price |
$952.50
|
| Rate for Payer: Cigna Commercial |
$1,581.15
|
| Rate for Payer: First Health Commercial |
$1,809.75
|
| Rate for Payer: Humana Commercial |
$1,619.25
|
| Rate for Payer: Humana KY Medicaid |
$655.13
|
| Rate for Payer: Humana Medicare Advantage |
$135.08
|
| Rate for Payer: Kentucky WC Medicaid |
$661.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,562.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,405.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$162.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$668.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,676.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,428.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$381.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$247.65
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$590.55
|
| Rate for Payer: PHCS Commercial |
$1,828.80
|
| Rate for Payer: United Healthcare All Payer |
$1,676.40
|
|
|
HOME SLEEP STUDY
|
Facility
|
IP
|
$443.00
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$57.59 |
| Max. Negotiated Rate |
$425.28 |
| Rate for Payer: Aetna Commercial |
$341.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$345.54
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cigna Commercial |
$367.69
|
| Rate for Payer: First Health Commercial |
$420.85
|
| Rate for Payer: Humana Commercial |
$376.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$363.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$326.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$132.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$389.84
|
| Rate for Payer: Ohio Health Group HMO |
$332.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$88.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$57.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$137.33
|
| Rate for Payer: PHCS Commercial |
$425.28
|
| Rate for Payer: United Healthcare All Payer |
$389.84
|
|
|
HOME SLEEP STUDY
|
Professional
|
Both
|
$1,905.00
|
|
|
Service Code
|
HCPCS 95806
|
| Hospital Charge Code |
92000013
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$75.36 |
| Max. Negotiated Rate |
$1,905.00 |
| Rate for Payer: Aetna Commercial |
$324.29
|
| Rate for Payer: Anthem Medicaid |
$246.64
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,905.00
|
| Rate for Payer: Cash Price |
$952.50
|
| Rate for Payer: Cash Price |
$952.50
|
| Rate for Payer: Cigna Commercial |
$308.71
|
| Rate for Payer: Healthspan PPO |
$283.61
|
| Rate for Payer: Humana Medicaid |
$246.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$75.36
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$251.57
|
| Rate for Payer: Molina Healthcare Passport |
$246.64
|
| Rate for Payer: Multiplan PHCS |
$1,143.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,333.50
|
| Rate for Payer: UHCCP Medicaid |
$666.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$249.11
|
|
|
HOME SLEEP STUDY
|
Facility
|
OP
|
$443.00
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$57.59 |
| Max. Negotiated Rate |
$425.28 |
| Rate for Payer: Aetna Commercial |
$341.11
|
| Rate for Payer: Anthem Medicaid |
$152.35
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$135.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$345.54
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$189.11
|
| Rate for Payer: CareSource Just4Me Medicare |
$182.36
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cigna Commercial |
$367.69
|
| Rate for Payer: First Health Commercial |
$420.85
|
| Rate for Payer: Humana Commercial |
$376.55
|
| Rate for Payer: Humana KY Medicaid |
$152.35
|
| Rate for Payer: Humana Medicare Advantage |
$135.08
|
| Rate for Payer: Kentucky WC Medicaid |
$153.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$363.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$326.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$162.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$155.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$389.84
|
| Rate for Payer: Ohio Health Group HMO |
$332.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$88.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$57.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$137.33
|
| Rate for Payer: PHCS Commercial |
$425.28
|
| Rate for Payer: United Healthcare All Payer |
$389.84
|
|
|
HOME SLEEP STUDY
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$39.71 |
| Max. Negotiated Rate |
$443.00 |
| Rate for Payer: Aetna Commercial |
$240.12
|
| Rate for Payer: Buckeye Medicare Advantage |
$443.00
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$39.71
|
| Rate for Payer: Multiplan PHCS |
$265.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$310.10
|
| Rate for Payer: UHCCP Medicaid |
$155.05
|
|
|
HOME SLEEP STUDY(P
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 95806
|
| Hospital Charge Code |
920P0013
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$75.36 |
| Max. Negotiated Rate |
$324.29 |
| Rate for Payer: Aetna Commercial |
$324.29
|
| Rate for Payer: Anthem Medicaid |
$246.64
|
| Rate for Payer: Buckeye Medicare Advantage |
$225.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cigna Commercial |
$308.71
|
| Rate for Payer: Healthspan PPO |
$283.61
|
| Rate for Payer: Humana Medicaid |
$246.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$75.36
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$251.57
|
| Rate for Payer: Molina Healthcare Passport |
$246.64
|
| Rate for Payer: Multiplan PHCS |
$135.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$157.50
|
| Rate for Payer: UHCCP Medicaid |
$78.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$249.11
|
|
|
HOME SLEEP STUDY(T
|
Facility
|
OP
|
$1,680.00
|
|
|
Service Code
|
HCPCS 95806
|
| Hospital Charge Code |
920T0013
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$135.08 |
| Max. Negotiated Rate |
$1,612.80 |
| Rate for Payer: Aetna Commercial |
$1,293.60
|
| Rate for Payer: Anthem Medicaid |
$577.75
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$135.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,310.40
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$189.11
|
| Rate for Payer: CareSource Just4Me Medicare |
$182.36
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cigna Commercial |
$1,394.40
|
| Rate for Payer: First Health Commercial |
$1,596.00
|
| Rate for Payer: Humana Commercial |
$1,428.00
|
| Rate for Payer: Humana KY Medicaid |
$577.75
|
| Rate for Payer: Humana Medicare Advantage |
$135.08
|
| Rate for Payer: Kentucky WC Medicaid |
$583.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,377.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,239.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$162.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$589.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,478.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,260.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$336.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$218.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$520.80
|
| Rate for Payer: PHCS Commercial |
$1,612.80
|
| Rate for Payer: United Healthcare All Payer |
$1,478.40
|
|
|
HOME SLEEP STUDY(T
|
Facility
|
IP
|
$1,680.00
|
|
|
Service Code
|
HCPCS 95806
|
| Hospital Charge Code |
920T0013
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$218.40 |
| Max. Negotiated Rate |
$1,612.80 |
| Rate for Payer: Aetna Commercial |
$1,293.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,310.40
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cigna Commercial |
$1,394.40
|
| Rate for Payer: First Health Commercial |
$1,596.00
|
| Rate for Payer: Humana Commercial |
$1,428.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,377.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,239.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$504.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,478.40
|
| Rate for Payer: Ohio Health Group HMO |
$1,260.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$336.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$218.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$520.80
|
| Rate for Payer: PHCS Commercial |
$1,612.80
|
| Rate for Payer: United Healthcare All Payer |
$1,478.40
|
|
|
HOME VISIT/25 MINUTES
|
Facility
|
IP
|
$273.50
|
|
|
Service Code
|
HCPCS 99348
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.56 |
| Max. Negotiated Rate |
$262.56 |
| Rate for Payer: Aetna Commercial |
$210.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$213.33
|
| Rate for Payer: Cash Price |
$136.75
|
| Rate for Payer: Cigna Commercial |
$227.00
|
| Rate for Payer: First Health Commercial |
$259.82
|
| Rate for Payer: Humana Commercial |
$232.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$224.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$201.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$82.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$240.68
|
| Rate for Payer: Ohio Health Group HMO |
$205.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$54.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$84.78
|
| Rate for Payer: PHCS Commercial |
$262.56
|
| Rate for Payer: United Healthcare All Payer |
$240.68
|
|
|
HOME VISIT/25 MINUTES
|
Professional
|
Both
|
$273.50
|
|
|
Service Code
|
HCPCS 99348
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.48 |
| Max. Negotiated Rate |
$273.50 |
| Rate for Payer: Aetna Commercial |
$125.38
|
| Rate for Payer: Anthem Medicaid |
$78.48
|
| Rate for Payer: Buckeye Medicare Advantage |
$273.50
|
| Rate for Payer: Cash Price |
$136.75
|
| Rate for Payer: Cash Price |
$136.75
|
| Rate for Payer: Cigna Commercial |
$100.99
|
| Rate for Payer: Healthspan PPO |
$97.12
|
| Rate for Payer: Humana Medicaid |
$78.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$112.33
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$80.05
|
| Rate for Payer: Molina Healthcare Passport |
$78.48
|
| Rate for Payer: Multiplan PHCS |
$164.10
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$191.45
|
| Rate for Payer: UHCCP Medicaid |
$95.72
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$79.26
|
|
|
HOME VISIT/25 MINUTES
|
Facility
|
OP
|
$273.50
|
|
|
Service Code
|
HCPCS 99348
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.56 |
| Max. Negotiated Rate |
$262.56 |
| Rate for Payer: Aetna Commercial |
$210.60
|
| Rate for Payer: Anthem Medicaid |
$94.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$213.33
|
| Rate for Payer: Cash Price |
$136.75
|
| Rate for Payer: Cigna Commercial |
$227.00
|
| Rate for Payer: First Health Commercial |
$259.82
|
| Rate for Payer: Humana Commercial |
$232.48
|
| Rate for Payer: Humana KY Medicaid |
$94.06
|
| Rate for Payer: Kentucky WC Medicaid |
$95.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$224.27
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$201.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$82.05
|
| Rate for Payer: Molina Healthcare Medicaid |
$95.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$240.68
|
| Rate for Payer: Ohio Health Group HMO |
$205.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$54.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$84.78
|
| Rate for Payer: PHCS Commercial |
$262.56
|
| Rate for Payer: United Healthcare All Payer |
$240.68
|
|
|
HOME VISIT/25 MINUTES(P
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 99348
|
| Hospital Charge Code |
510P0085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$125.38 |
| Rate for Payer: Aetna Commercial |
$125.38
|
| Rate for Payer: Anthem Medicaid |
$78.48
|
| Rate for Payer: Buckeye Medicare Advantage |
$120.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$100.99
|
| Rate for Payer: Healthspan PPO |
$97.12
|
| Rate for Payer: Humana Medicaid |
$78.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$112.33
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$80.05
|
| Rate for Payer: Molina Healthcare Passport |
$78.48
|
| Rate for Payer: Multiplan PHCS |
$72.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$84.00
|
| Rate for Payer: UHCCP Medicaid |
$42.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$79.26
|
|
|
HOME VISIT/25 MINUTES(T
|
Facility
|
OP
|
$153.50
|
|
|
Service Code
|
HCPCS 99348
|
| Hospital Charge Code |
510T0085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.96 |
| Max. Negotiated Rate |
$147.36 |
| Rate for Payer: Aetna Commercial |
$118.20
|
| Rate for Payer: Anthem Medicaid |
$52.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$119.73
|
| Rate for Payer: Cash Price |
$76.75
|
| Rate for Payer: Cigna Commercial |
$127.40
|
| Rate for Payer: First Health Commercial |
$145.82
|
| Rate for Payer: Humana Commercial |
$130.48
|
| Rate for Payer: Humana KY Medicaid |
$52.79
|
| Rate for Payer: Kentucky WC Medicaid |
$53.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$125.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$113.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$46.05
|
| Rate for Payer: Molina Healthcare Medicaid |
$53.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$135.08
|
| Rate for Payer: Ohio Health Group HMO |
$115.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$30.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$47.58
|
| Rate for Payer: PHCS Commercial |
$147.36
|
| Rate for Payer: United Healthcare All Payer |
$135.08
|
|
|
HOME VISIT/25 MINUTES(T
|
Facility
|
IP
|
$153.50
|
|
|
Service Code
|
HCPCS 99348
|
| Hospital Charge Code |
510T0085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.96 |
| Max. Negotiated Rate |
$147.36 |
| Rate for Payer: Aetna Commercial |
$118.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$119.73
|
| Rate for Payer: Cash Price |
$76.75
|
| Rate for Payer: Cigna Commercial |
$127.40
|
| Rate for Payer: First Health Commercial |
$145.82
|
| Rate for Payer: Humana Commercial |
$130.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$125.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$113.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$46.05
|
| Rate for Payer: Ohio Health Choice Commercial |
$135.08
|
| Rate for Payer: Ohio Health Group HMO |
$115.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$30.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$19.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$47.58
|
| Rate for Payer: PHCS Commercial |
$147.36
|
| Rate for Payer: United Healthcare All Payer |
$135.08
|
|
|
HOME VISIT BRIEF
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 99347
|
| Hospital Charge Code |
51000084
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$77.00
|
| Rate for Payer: Anthem Medicaid |
$34.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$78.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$83.00
|
| Rate for Payer: First Health Commercial |
$95.00
|
| Rate for Payer: Humana Commercial |
$85.00
|
| Rate for Payer: Humana KY Medicaid |
$34.39
|
| Rate for Payer: Kentucky WC Medicaid |
$34.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$82.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$73.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$35.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$88.00
|
| Rate for Payer: Ohio Health Group HMO |
$75.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$20.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$31.00
|
| Rate for Payer: PHCS Commercial |
$96.00
|
| Rate for Payer: United Healthcare All Payer |
$88.00
|
|
|
HOME VISIT BRIEF
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99347
|
| Hospital Charge Code |
51000084
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$83.07
|
| Rate for Payer: Anthem Medicaid |
$53.11
|
| Rate for Payer: Buckeye Medicare Advantage |
$100.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$63.91
|
| Rate for Payer: Healthspan PPO |
$64.34
|
| Rate for Payer: Humana Medicaid |
$53.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$74.26
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$54.17
|
| Rate for Payer: Molina Healthcare Passport |
$53.11
|
| Rate for Payer: Multiplan PHCS |
$60.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$70.00
|
| Rate for Payer: UHCCP Medicaid |
$35.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$53.64
|
|
|
HOME VISIT BRIEF
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
HCPCS 99347
|
| Hospital Charge Code |
51000084
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$77.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$78.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$83.00
|
| Rate for Payer: First Health Commercial |
$95.00
|
| Rate for Payer: Humana Commercial |
$85.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$82.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$73.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$88.00
|
| Rate for Payer: Ohio Health Group HMO |
$75.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$20.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$31.00
|
| Rate for Payer: PHCS Commercial |
$96.00
|
| Rate for Payer: United Healthcare All Payer |
$88.00
|
|
|
HOME VISIT BRIEF(P
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99347
|
| Hospital Charge Code |
510P0084
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$83.07
|
| Rate for Payer: Anthem Medicaid |
$53.11
|
| Rate for Payer: Buckeye Medicare Advantage |
$100.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$63.91
|
| Rate for Payer: Healthspan PPO |
$64.34
|
| Rate for Payer: Humana Medicaid |
$53.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$74.26
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$54.17
|
| Rate for Payer: Molina Healthcare Passport |
$53.11
|
| Rate for Payer: Multiplan PHCS |
$60.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$70.00
|
| Rate for Payer: UHCCP Medicaid |
$35.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$53.64
|
|
|
HOME VISIT EST PT MOD-HI 40MIN
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 99349
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$61.25 |
| Max. Negotiated Rate |
$182.67 |
| Rate for Payer: Aetna Commercial |
$182.67
|
| Rate for Payer: Anthem Medicaid |
$115.76
|
| Rate for Payer: Buckeye Medicare Advantage |
$175.00
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cigna Commercial |
$156.09
|
| Rate for Payer: Healthspan PPO |
$141.50
|
| Rate for Payer: Humana Medicaid |
$115.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$166.10
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$118.08
|
| Rate for Payer: Molina Healthcare Passport |
$115.76
|
| Rate for Payer: Multiplan PHCS |
$105.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$122.50
|
| Rate for Payer: UHCCP Medicaid |
$61.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$116.92
|
|
