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

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

Fee ScheduleEffective Date
Assistive Care Services Fee Schedule Promulgated Fee Schedule [ pdf 10 kB ] 2023

Promulgated Fee Schedule [ pdf 10 kB ] July 2022
Behavior Analysis Fee Schedule Promulgated Fee Schedule [ pdf 50.6 kB ] 2023
Behavioral Health Overlay Services Fee Schedule Promulgated Fee Schedule [ pdf 29.5 kB ] 2023

Promulgated Fee Schedule [ pdf 29.5 kB ] July 2022
Birth Center Fee Schedule Promulgated Fee Schedule [ pdf 94.8 kB ] 2023
Promulgated XLS [ excel 70.9 kB ] 2023

Promulgated Fee Schedule [ pdf 92 kB ] July 2022
Promulgated XLS [ excel 70.7 kB ] July 2022
Child Health Targeted Case Management Services Fee Schedule Promulgated Fee Schedule [ pdf 107.6 kB ] 2023

Promulgated Fee Schedule [ pdf 107.6 kB ] July 2022
Community-Based Substance Abuse County Match Fee Schedule Promulgated Fee Schedule [ pdf 30.7 kB ] 2023
Community Behavioral Health Services Fee Schedule Updated Fee Schedule [ pdf 626.1 kB ]  Effective 10/1/2023
Updated XLS [ excel 19.8 kB ] Effective 10/1/2023

Promulgated Fee Schedule [ pdf 181.5 kB ] 2023
Promulgated XLS [ excel 13.7 kB ] 2023

Promulgated Fee Schedule [ pdf 560.9 kB ] July 2022
Promulgated XLS [ excel 13.4 kB ] July 2022
County Health Department Certified Match Program Fee Schedule Promulgated Fee Schedule [ pdf 82.9 kB ] 2023
Dental General Fee Schedule Promulgated Fee Schedule [ pdf 149.1 kB ] 2023
Promulgated XLS [ excel 117 kB ]  2023

Promulgated Fee Schedule [ pdf 145.7 kB ] July 2022
Promulgated  XLS [ excel 117.2 kB ] July 2022
Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients Updated Fee Schedule [ pdf 966.3 kB ]  Effective 10/1/2023
Updated XLS [ excel 133.8 kB ] Effective 10/1/2023

Promulgated Fee Schedule [ pdf 989.8 kB ] 2023
Promulgated XLS [ excel 133.3 kB ]  2023

Promulgated Fee Schedule [ pdf 1.1 MB ] 2022
Promulgated XLS [ excel 128 kB ] 2022
Early Intervention Services Fee Schedule Promulgated Fee Schedule [ pdf 19.4 kB ] 2023

Promulgated Fee Schedule [ pdf 94.4 kB ] 2022
Hearing Services Fee Schedule Promulgated Fee Schedule [ pdf 38.8 kB ] 2023
Promulgated XLS [ excel 155.6 kB ]  2023

Promulgated Fee Schedule [ pdf 42.1 kB ] July 2022
Promulgated XLS [ excel 156.1 kB ] July 2022
Home Health Visit Services Fee Schedule Promulgated Fee Schedule [ pdf 61.5 kB ] 2023

Promulgated Fee Schedule [ pdf 61.5 kB ] July 2022
Independent Laboratory Fee Schedule Promulgated Fee Schedule [ pdf 427.4 kB ] 2023
Promulgated XLS [ excel 86 kB ]  2023

Promulgated Fee Schedule [ pdf 378.2 kB ] July 2022
Promulgated  XLS [ excel 82.2 kB ] July 2022
Licensed Midwife Fee Schedule Promulgated Fee Schedule [ pdf 135.9 kB ] 2023
Promulgated XLS [ excel 113.6 kB ]  2023

Promulgated Fee Schedule [ pdf 137.1 kB ] July 2022
Promulgated XLS [ excel 113.5 kB ] July 2022
Medicaid Certified School Match Program Fee Schedule Promulgated Fee Schedule [ pdf 133.2 kB ] 2023

Promulgated Fee Schedule [ pdf 167.9 kB ] 2022
Medical Foster Care Services Fee Schedule Promulgated Fee Schedule [ pdf 9.8 kB ] 2023

Promulgated Fee Schedule [ pdf 9.9 kB ] July 2022
Mental Health Targeted Case Management Services Fee Schedule Promulgated Fee Schedule [ pdf 107.6 kB ] 2023

Promulgated Fee Schedule [ pdf 107.6 kB ] July 2022
Occupational Therapy Services Fee Schedule Promulgated Fee Schedule [ pdf 35.2 kB ] 2023

Promulgated Fee Schedule [ pdf 43.2 kB ] July 2022
Personal Care Services Fee Schedule Promulgated Fee Schedule [ pdf 51.9 kB ] 2023

Promulgated Fee Schedule [ pdf 51.9 kB ] July 2022
Physical Therapy Services Fee Schedule Promulgated Fee Schedule [ pdf 35.3 kB ] 2023

Promulgated Fee Schedule [ pdf 42.9 kB ] July 2022
Physician Pediatric Surgery Fee Schedule Promulgated Fee Schedule [ pdf 146.4 kB ] 2023
Promulgated XLS [ excel 20.1 kB ] 2023

Promulgated Fee Schedule [ pdf 146.2 kB ] 2022
Promulgated XLS [ excel 20.1 kB ] 2022
Practitioner Fee Schedule Updated Fee Schedule [ pdf 1.1 MB ]  Effective 10/1/2023
Updated XLS [ excel 271.4 kB ] Effective 10/1/2023

Promulgated Fee Schedule [ pdf 3 MB ] 2023
Promulgated XLS [ excel 274.5 kB ] 2023

Promulgated Fee Schedule [ pdf 904.5 kB ] July 2022
Promulgated XLS [ excel 280.3 kB ] July 2022
Practitioner Laboratory Fee Schedule

(Formerly titled Physician and Outpatient Laboratory Fee Schedule)
Promulgated Fee Schedule [ pdf 456.1 kB ] 2023
Promulgated XLS [ excel 118.2 kB ] 2023

Promulgated Fee Schedule [ pdf 592.7 kB ] July 2022
Promulgated XLS [ excel 114.4 kB ] July 2022
Prescribed Drugs Immunization Fee Schedule Updated Fee Schedule [ pdf 263.9 kB ] Effective 10/1/23
Updated XLS [ excel 19.8 kB ] Effective 10/1/23

Promulgated Fee Schedule [ pdf 279.7 kB ] 2023
Promulgated XLS [ excel 20.1 kB ]  2023
Prescribed Pediatric Extended Care Services Fee Schedule Updated Fee Schedule [ pdf 67.2 kB ]  Effective 7/1/2023

Promulgated Fee Schedule [ pdf 67.1 kB ] Effective 1/1/2023

Promulgated Fee Schedule [ pdf 67.2 kB ] July 2022
Private Duty Nursing Services Fee Schedule Promulgated Fee Schedule [ pdf 63.3 kB ] 2023

Promulgated Fee Schedule [ pdf 63.3 kB ] July 2022
Radiology Fee Schedule Promulgated Fee Schedule [ pdf 421.7 kB ] 2023
Promulgated XLS [ excel 39.8 kB ] 2023

Promulgated Fee Schedule [ pdf 414.6 kB ] July 2022
Promulgated XLS [ excel 114.6 kB ] July 2022
Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule Promulgated Fee Schedule [ pdf 50 kB ] 2023
Promulgated XLS [ excel 12.1 kB ] 2023
Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule Promulgated Fee Schedule [ pdf 47.5 kB ] 2023
Promulgated XLS [ excel 12.2 kB ] 2023
Respiratory Therapy Services Promulgated Fee Schedule [ pdf 29.7 kB ] 2023

Promulgated Fee Schedule [ pdf 100.5 kB ] July 2022
Specialized Therapeutic Services Fee Schedule Promulgated Fee Schedule [ pdf 102.6 kB ] 2023

Promulgated Fee Schedule [ pdf 103.8 kB ] July 2022
Speech-Language Pathology Services Fee Schedule Promulgated Fee Schedule [ pdf 38.1 kB ] 2023

Promulgated Fee Schedule [ pdf 39.1 kB ] July 2022
Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule Promulgated Fee Schedule [ pdf 107.6 kB ] 2023

Promulgated Fee Schedule [ pdf 107.6 kB ] July 2022
Transportation Services Fee Schedule Promulgated Fee Schedule [ pdf 19.5 kB ] 2023

Promulgated Fee Schedule [ pdf 19.5 kB ] July 2022
Visual Services Fee Schedule Promulgated Fee Schedule [ pdf 41.6 kB ] 2023
Promulgated XLS [ excel 115.1 kB ] 2023

Promulgated Fee Schedule [ pdf 42.4 kB ] July 2022
Promulgated XLS [ excel 116.3 kB ] July 2022
Billing CodeEffective Date
County Health Department Billing Codes Promulgated Billing Code [ pdf 109.7 kB ] 2023
Federally Qualified Health Center Billing Codes Promulgated Billing Code [ pdf 111.2 kB ] 2023
Hospice Services Billing Codes Promulgated Billing Code [ pdf 109.8 kB ] 2023
Hospital Outpatient Services Billing Codes Promulgated Billing Code [ pdf 165.6 kB ] 2023
Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes Promulgated Billing Code [ pdf 8.9 kB ] 2023
Nursing Facility Services Billing Codes Promulgated Billing Code [ pdf 8.8 kB ] 2023
Prescribed Drugs Physician Administered Billing Codes Promulgated Billing Code [ pdf 311.6 kB ] 2023
Promulgated XLS [ excel 29.3 kB ] 2023
Rural Health Clinic Billing Codes Promulgated Billing Code [ pdf 104.6 kB ] 2023
Statewide Inpatient Psychiatric Program Services Billing Codes Promulgated Billing Code [ pdf 9.3 kB ] 2023

Historical Medicaid Reimbursement Schedules