2012 Specialty Pricing

(Effective for dates of service 01/01/2012 and after.)

Ambulance

Ambulatory Surgical Center (ASC)

Anesthesia

Average Sales Price (ASP) Drug Pricing

Chiropractic and Clinical Psychologist

The chiropractic and clinical psychologist fees are available in the Medicare Physician Fee Schedule.

Clinical Social Worker

The clinical social worker fees are available in the Medicare Physician Fee Schedule. To determine the fee, multiply the fee amount by 75%.

Labs

Durable Medical Equipment, Prosthetics, and Orthotics (DMEPOS)

Medical Nutrition Therapy

The medical nutrition therapy fees are available in the Medicare Physician Fee Schedule. To determine the fee, multiply the fee amount by 85%. (Exception - The 85% calculation does not apply to Codes G0108 and G0109).

Nurse Practitioner / Physician Assistant / Clinical Nurse Specialist

The NP, PA and CNS fees are available in the Medicare Physician Fee Schedule. To determine the fee, multiply the fee amount by 85%. (Exception - The 85% calculation does not apply to codes with a TC modifier, Technical Component Only codes or CPT codes G0108 and G0109).

Splints and Casts

Vaccinations (Influenza (flu) and Pneumococcal)

Note: Administration codes G0008, G0009, G0010, G9141 are priced based on the MPFSDB fee for code 90471.

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Page Last Updated: Tuesday, 15-May-2012 08:45:35 CDT