99202
|
New Patient Office or Other Outpatient Service (20 minutes)
|
$69.87
|
| 99203 |
New Patient Office or Other Outpatient Service (30 minutes) |
$109.01
|
99204
|
New Patient Office or Other Outpatient Service (45 minutes) |
$163.35
|
| 99205 |
New Patient Office or Other Outpatient Service (60 minutes) |
$215.75
|
| 99211 |
Established Patient Office or Other Outpatient Service (5 minutes) |
$22.64
|
| 99212 |
Established Patient Office or Other Outpatient Service (10 minutes) |
$54.99
|
| 99213 |
Established Patient Office or Other Outpatient Service (15 minutes) |
$88.95
|
99214
|
Established Patient Office or Other Outpatient Service (25 minutes) |
$125.18
|
| 99215 |
Established Patient Office or Other Outpatient Service (40 minutes) |
$175.64
|
| 90471 |
Immunization Administration |
$20.05
|
| 90472 |
Immunization Administration, Each Additional |
$14.23
|
| 90473 |
Immunization Administration, Intranasal or Oral |
$16.17
|
| 90474 |
Immunization Administration, Each Additional Intranasal or Oral |
$11.64
|
90739
| HEPB Vacc 2/4 DOSE Adult IM
| $182.02
|
J0738
| Injection, Cabotegravir 1 mg, FDA approved prescription
| $19.67
|
J0739
| Injection, Cabotegravir 1 mg
| $11.35
|
J0752
| Oral, Lenacapavir, 300 mg, FDA approved prescription
| $587.88
|
| 96372 |
Therapeutic, Prophylactic, & Diagnostic Injections and Infusions |
$13.91
|
96373
|
Therapeutic, Prophylactic, & Diagnostic Injections and Infusions
|
$18.44
|
98016
| Brief Communication Technology-Based Service
| $15.58
|
99384
| Preventive Medicine Visits Age 12-17
| $65.78
|
99385
| Preventive Medicine Visits Age 19-39
| $114.10
|
99386
| Preventive Medicine Visits Age 40-64
| $132.20
|
99387
| Preventive Medicine Visits Age 65 and older
| $143.00
|
99394
| Preventive Medicine Visits Age 12-17
| $126.83
|
99395
| Preventive Medicine Visits Age 18-39
| $54.83
|
99396
| Preventive Medicine Visits Age 40-64
| $109.90
|
99397
| Preventive Medicine Visits Age 65 and older
| $118.40
|
99401
| Preventive Medicine Visits - approximately 15 minutes
| $12.94
|
99402
| Preventive Medicine Visits approximately 30 minutes
| $25.58
|
99403
| Preventive Medicine Visitis approximately 45 minutes
| $38.37
|
99404
| Preventive Medicine Visitis approximately 60 minutes
| $51.16
|
99411
| Preventive Medicine Visits approximately 30 minutes
| $18.79
|
99412
| Preventive Medicine Visits approximately 60 minutes
| $23.27
|
| 99421 |
Online Digital Evaluation and Management Service (5-10 minutes) |
$14.56
|
| 99422 |
Online Digital Evaluation and Management Service (11-20 minutes) |
$28.46
|
| 99423 |
Online Digital Evaluation and Management Service (21 or more minutes) |
$44.96
|
| 99441 |
Audio-only (Telephone) Evaluation and Management Service (5-10 minutes) |
$56.25
|
| 99442 |
Audio-only (Telephone) Evaluation and Management Service (11-20 minutes) |
$90.82 |
| 99443 |
Audio-only (Telephone) Evaluation and Management Service (21-30 minutes) |
$127.76
|
| 98970 |
Qualified Nonphysician Health Care Professional Online Digital Evaluation and Management Service (5-10 minutes) |
$11.32
|
| 98971 |
Qualified Nonphysician Health Care Professional Online Digital Evaluation and Management Service (11-20 minutes) |
$21.35
|
| 98972 |
Qualified Nonphysician Health Care Professional Online Digital Evaluation and Management Service (21-30 minutes) |
$32.35
|
| G2010 |
Remote Evaluation of Recorded Video and/or Images Submitted by an Established Patient
|
$11.97
|
G2012
| Brief Communication Technology-based Service (5-10 minutes)
| $14.23
|
G2250
|
Remote Evaluation of Recorded Video and/or Images Submitted by an Established Patient |
$11.97
|
| G2251 |
Brief Communication Technology-based Service (5-10 minutes) |
$13.91
|
| G2252 |
Brief Communication Technology-based Service (11-20 minutes) |
$25.55
|