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

Fee Schedule	Effective Date
Ambulatory Surgical Center Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Assistive Care Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Behavior Analysis Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Behavioral Health Overlay Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Birth Center Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Child Health Services Targeted Case Management Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Community-Based Substance Abuse County Match Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Community Behavioral Health Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
County Health Department Certified Match Program Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Dental General Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for Medicaid Recipients Under the Age of 21 Years	Promulgated Fee Schedule 1/1/2017 XLS
Early Intervention Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Emergency Transportation Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Hearing Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Home Health Visit Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Immunization Fee Schedule	Promulgated Fee Schedule 10/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Independent Laboratory Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Injectable Medications Oncology Fee Schedule	Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Licensed Midwife Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Medicaid Certified School Match Program Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Medical Foster Care Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Mental Health Targeted Case Management Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Occupational Therapy Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Outpatient Laboratory Fee Schedule (Formerly titled Physician and Outpatient Laboratory Fee Schedule)	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Personal Care Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Physical Therapy Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Physician Pediatric Surgery Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Practitioner Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Practitioner Laboratory Fee Schedule (Formerly titled Physician and Outpatient Laboratory Fee Schedule)	Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Prescribed Drug (Not Reviewed by the Pharmaceutical and Therapeutics Committee) Fee Schedule (Formerly titled Injectable Medications Non-Oncology Fee Schedule)	Promulgated Fee Schedule 1/1/2017 XLS *Updated Fee Schedule 1/1/2018
Prescribed Pediatric Extended Care Services Fee Schedule	Promulgated Fee Schedule 1/1/2018
Private Duty Nursing Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Radiology Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018
Respiratory Therapy Services	Promulgated Fee Schedule 7/1/2017 *Updated Fee Schedule 1/1/2018
Specialized Therapeutic Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Speech-Language Pathology Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 *Updated Fee Schedule 1/1/2018
Visual Services Fee Schedule	Promulgated Fee Schedule 1/1/2017 XLS Updated Fee Schedule 1/1/2018 Updated XLS 1/1/2018

*Fee Schedules not yet promulgated.

Billing Code	Effective Date
County Health Department Billing Codes	Promulgated Billing Code 1/1/2017 *Updated Billing Code 1/1/2018
Federally Qualified Health Center Billing Codes	Promulgated Billing Code 1/1/2017 *Updated Billing Code 1/1/2018
Hospice Services Billing Codes	Promulgated Billing Code 1/1/2017 *Updated Billing Code 1/1/2018
Hospital Outpatient Services Billing Codes	Promulgated Billing Code 1/1/2017 *Updated Billing Code 1/1/2018
Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes	Promulgated Billing Code 1/1/2017 *Updated Billing Code 1/1/2018
Nursing Facility Services Billing Codes	Promulgated Billing Code 1/1/2017 *Updated Billing Code 1/1/2018
Rural Health Clinic Billing Codes	Promulgated Billing Code 1/1/2017 *Updated Billing Code 1/1/2018
Statewide Inpatient Psychiatric Program Services Billing Codes	Promulgated Billing Code 1/1/2017 *Updated Billing Code 1/1/2018

*Billing codes not yet promulgated.