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

Fee Schedule	Effective Date
Ambulatory Surgical Center Services Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021
Assistive Care Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Behavior Analysis Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Behavioral Health Overlay Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Birth Center Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Child Health Targeted Case Management Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Community-Based Substance Abuse County Match Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Community Behavioral Health Services Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
County Health Department Certified Match Program Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Dental General Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Early Intervention Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Hearing Services Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Home Health Visit Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Independent Laboratory Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Licensed Midwife Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Medicaid Certified School Match Program Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Medical Foster Care Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Mental Health Targeted Case Management Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Occupational Therapy Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Outpatient Laboratory Fee Schedule (Formerly titled Physician and Outpatient Laboratory Fee Schedule)	Promulgated Fee Schedule 2021 Promulgated XLS 2021
Personal Care Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Physical Therapy Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Physician Pediatric Surgery Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Practitioner Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Practitioner Laboratory Fee Schedule (Formerly titled Physician and Outpatient Laboratory Fee Schedule)	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Prescribed Drugs Immunization Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Prescribed Pediatric Extended Care Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Private Duty Nursing Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Radiology Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022
Respiratory Therapy Services	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Specialized Therapeutic Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Speech-Language Pathology Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Transportation Services Fee Schedule	Promulgated Fee Schedule 2021 Updated Fee Schedule 2022
Visual Services Fee Schedule	Promulgated Fee Schedule 2021 Promulgated XLS 2021 Updated Fee Schedule 2022 Updated XLS 2022

Billing Code	Effective Date
County Health Department Billing Codes	Promulgated Billing Code 2021 Updated Billing Code 2022
Federally Qualified Health Center Billing Codes	Promulgated Billing Code 2021 Updated Billing Code 2022
Hospice Services Billing Codes	Promulgated Billing Code 2021 Updated Billing Code 2022
Hospital Outpatient Services Billing Codes	Promulgated Billing Code 2021 Updated Billing Code 2022
Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes	Promulgated Billing Code 2021 Updated Billing Code 2022
Nursing Facility Services Billing Codes	Promulgated Billing Code 2021 Updated Billing Code 2022
Prescribed Drugs Physician Administered Billing Codes	Promulgated Billing Code 2021 Promulgated XLS 2021 Updated Billing Code 2022 Updated XLS 2022
Rural Health Clinic Billing Codes	Promulgated Billing Code 2021 Updated Billing Code 2022
Statewide Inpatient Psychiatric Program Services Billing Codes	Promulgated Billing Code 2021 Updated Billing Code 2022