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

Fee Schedule Effective Date
Ambulatory Surgical Center Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2015
Updated Fee Schedule* 1/1/2017
Assistive Care Services Fee Schedule Promulgated Fee Schedule 1/1/2016
Updated Fee Schedule* 1/1/2017
Behavior Analysis Fee Schedule Promulgated Fee Schedule 1/1/2016
Updated Fee Schedule* 1/1/2017
Behavioral Health Overlay Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Birth Center Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 8/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Child Health Services Targeted Case Management Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Community-Based Substance Abuse County Match Fee Schedule Promulgated Fee Schedule 1/1/2016
Updated Fee Schedule* 1/1/2017
Community Behavioral Health Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
County Health Department Certified Match Program Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Dental General Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for Medicaid Recipients
Under the Age of 21 Years
Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Early Intervention Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Emergency Transportation Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Hearing Services Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Home Health Visit Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Immunization Fee Schedule Promulgated Fee Schedule 8/1/2015
XLS
Updated Fee Schedule* 1/1/2017
XLS
Independent Laboratory Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Injectable Medications Non-Oncology Fee Schedule Fee Schedule* 5/1/2016
XLS
Injectable Medications Oncology Fee Schedule Fee Schedule* 5/1/2016
XLS
Licensed Midwife Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 8/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Medicaid Certified School Match Program Fee Schedule Promulgated Fee Schedule 1/1/2016
Updated Fee Schedule* 1/1/2017
Medical Foster Care Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Mental Health Targeted Case Management Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Occupational Therapy Services Fee Schedule Promulgated Fee Schedule 1/1/2016
Updated Fee Schedule* 1/1/2017
Personal Care Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Physical Therapy Services Fee Schedule Promulgated Fee Schedule 1/1/2016
Updated Fee Schedule* 1/1/2017
Physician and Outpatient Laboratory Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Physician Pediatric Surgery Fee Schedule Updated Fee Schedule * 1/1/2017
XLS
Practitioner Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 7/1/2016
Updated Fee Schedule* 8/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Prescribed Pediatric Extended Care Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Private Duty Nursing Services Fee Schedule Promulgated Fee Schedule 7/1/2016
Updated Fee Schedule* 1/1/2017
Radiology Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS
Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule Updated Fee Schedule* 1/1/2017
XLS
Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule Updated Fee Schedule* 1/1/2017
XLS
Respiratory Therapy Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Specialized Therapeutic Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Speech-Language Pathology Services Fee Schedule Promulgated Fee Schedule 1/1/2016
Updated Fee Schedule* 1/1/2017
Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule Promulgated Fee Schedule 1/1/2015
Updated Fee Schedule* 1/1/2017
Visual Services Fee Schedule Promulgated Fee Schedule 1/1/2016
XLS
Updated Fee Schedule* 1/1/2017
XLS

*Fee Schedule has not been promulgated.

Billing Code Effective Date
County Health Department Billing Codes Promulgated Billing Code 1/1/2016
Updated Billing Code* 1/1/2017
Federally Qualified Health Center Billing Codes Promulgated Billing Code 1/1/2016
Updated Billing Code* 1/1/2017
Hospice Services Billing Codes Promulgated Billing Code 1/1/2016
Updated Billing Code* 1/1/2017
Hospital Outpatient Services Billing Codes Promulgated Billing Code 1/1/2015
Updated Billing Code* 1/1/2017
Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes Promulgated Billing Code 1/1/2015
Updated Billing Code* 1/1/2017
Nursing Facility Services Billing Codes Promulgated Billing Code 1/1/2015
Updated Billing Code* 1/1/2017
Rural Health Clinic Billing Codes Promulgated Billing Code 1/1/2016
Updated Billing Code* 1/1/2017
Statewide Inpatient Psychiatric Program Services Billing Codes Promulgated Billing Code 1/1/2015
Updated Billing Code* 1/1/2017