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Rule 59G-4.002, Provider Reimbursement Schedules and Billing Codes

Fee Schedule Effective Date
Ambulatory Surgical Center Services Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Assistive Care Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Behavior Analysis Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 1/1/2020
Behavioral Health Overlay Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Birth Center Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Child Health Targeted Case Management Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Community-Based Substance Abuse County Match Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Community Behavioral Health Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
County Health Department Certified Match Program Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Dental General Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Early Intervention Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Hearing Services Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Home Health Visit Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Independent Laboratory Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Licensed Midwife Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Medicaid Certified School Match Program Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Medical Foster Care Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Mental Health Targeted Case Management Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Occupational Therapy Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Outpatient Laboratory Fee Schedule
(Formerly titled Physician and Outpatient Laboratory Fee Schedule)
Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Personal Care Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Physical Therapy Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Physician Pediatric Surgery Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Practitioner Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Practitioner Laboratory Fee Schedule
(Formerly titled Physician and Outpatient Laboratory Fee Schedule)
Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Prescribed Drugs Immunization Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Prescribed Drugs Oncology Physician Administered Fee Schedule Fee Schedule 1/1/2019
XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Prescribed Drugs Physician Administered Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Prescribed Pediatric Extended Care Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Private Duty Nursing Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Radiology Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020
Respiratory Therapy Services Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Specialized Therapeutic Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Speech-Language Pathology Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Transportation Services Fee Schedule Promulgated Fee Schedule 1/1/2019

Updated Fee Schedule 1/1/2020
Visual Services Fee Schedule Promulgated Fee Schedule 1/1/2019
Promulgated XLS 1/1/2019

Updated Fee Schedule 1/1/2020
Updated XLS 1/1/2020

Billing Code Effective Date
County Health Department Billing Codes Promulgated Billing Code 1/1/2019

Updated Billing Code 1/1/2020
Federally Qualified Health Center Billing Codes Promulgated Billing Code 1/1/2019

Updated Billing Code 1/1/2020
Hospice Services Billing Codes Promulgated Billing Code 1/1/2019

Updated Billing Code 1/1/2020
Hospital Outpatient Services Billing Codes Promulgated Billing Code 1/1/2019

Updated Billing Code 1/1/2020
Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes Promulgated Billing Code 1/1/2019

Updated Billing Code 1/1/2020
Nursing Facility Services Billing Codes Promulgated Billing Code 1/1/2019

Updated Billing Code 1/1/2020
Rural Health Clinic Billing Codes Promulgated Billing Code 1/1/2019

Updated Billing Code 1/1/2020
Statewide Inpatient Psychiatric Program Services Billing Codes Promulgated Billing Code 1/1/2019

Updated Billing Code 1/1/2020