Fee Schedules

Physicians

Enhanced Qualifying Primary Care

Family Practice, General Practice, Osteopath, Internal Medicine, Pediatrics, Geriatrics

Effective For Dates Of Service 01/01/16

Obstetrics, OB/GYN, Maternal Fetal Medicine

Effective For Dates Of Service 01/01/16

All other physicians

excluding Obstetrics, OB/GYN, Maternal Fetal Medicine

Effective For Dates Of Service 01/01/16

 

Pediatric

Pediatric Subspecialist excluding Neonatologist

Effective For Dates Of Service 01/01/16

Neonatologist

Effective For Dates Of Service 01/01/16

Anesthesiologist

Effective For Dates Of Service 01/01/16

Injectable Drug Fee

Effective For Dates Of Service 01/01/16

Independent Lab and X-ray

Effective For Dates Of Service 01/01/2016

Independent Lab

Effective For Dates Of Service 01/01/2014

Out-Patient Surgical Fee Schedule

Effective for Dates of Service 01/01/2015

 

Private and School Base Rehabilitative Therapy Services

School-Based Therapy Services

Effective For Dates Of Service 01/01/2013

Private Therapy Services

Effective For Dates of Service 07/01/2011

Dental Services

Effective For Dates Of Service 07/11/2011

Oral and Maxillofacial Surgeons

Effective For Dates Of Service 07/11/2011

 

Durable Medical Equipment

Effective For Dates Of Service 01/01/2016

 

Incontinence Supplies

Effective For Dates Of Service 07/11/2011

 

Rehabilitative Behavioral Health 

Effective For Dates Of Service 7-1-2016

Effective For Dates Of Service 1-1-2016

 

Vision Fee Schedule

Effective For Dates Of Service 12/01/2014

 

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