D.C. Mun. Regs. tit. 29, r. 29-992

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 29-992 - REIMBURSEMENT TO FEE-FOR-SERVICE PROVIDERS FOR SELECTED FREQUENT PROCEDURES
992.1

The Department shall reimburse a fee-for-service provider for the following frequent procedures or services:

Selected Frequent Procedures

Procedure Code

Price

Microbial Identification, Nucleic Acid

87178

$14.18

Initial Medical Visit - DHS

90020 Y4

94.64

Followup Medical Visit - DHS

90060 Y4

94.64

Individual Medical Psychotherapy

90844

37.80

Hemodialysis Procedure w/single

90935

115.20

FRSDC/All Inclusive Dialysis Service

90955 YD

162.00

Echocardiography/realtime w/IMA

93307

112.50

Office Visit, new patient

99205

58.50

Brief Consult/Nurse or non-MD visit

99211 Y4

94.64

Brief Consult/Nurse or non-MD visit

99211 Y5

94.64

Office visit, established patient

99212

18.00

Office visit, established patient

99213

18.00

Office visit, established patient

99214

27.00

Office visit, established patient

99215

40.50

Initial Hospital Care

99221

31.50

Initial Hospital Care

99222

36.00

Initial Hospital Care

99223

40.50

Subsequent Hospital Care, H/P LowCom

99231

16.20

Subsequent Hospital Care

99232

16.20

Subsequent Hospital Care/Day

99233

33.30

Initial Inpatient Consultation

99254

54.00

Emergency Department Visit

99282

17.42

Emergency Department Visit

99283

25.71

Emergency Department Visit

99284

39.13

Critical Care Evaluation and Monitoring

99291

50.40

Periodic Preventive Medicine Re-evaluation

99392

23.40

Community Health Care Clinic visit

99502

68.98

Individual Psychotherapy, Psychiatrist/FSMHC

H5010 Y3

67.50

Individual Psychotherabpy, Mental Health Professional

H5015

58.50

Psychotherapy Group

H5020

27.00

Group Therapy (MD or MHP)

H5030

36.00

Comprehensive Evaluation

H5040

180.00

Single VC Service made by Provider

Y2344

17.87

Bifocal VC Serv. made by Provider

Y2345

20.75

Prescription/Medication Assessment.FSMHC

Y3907

31.50

Family Therapy/MHP/FSMHC

Y3908

54.00

Partial Day Programs/Adults

Y5909

105.30

Children's Program

Y6909

108.00

Extended Therapy

Y7909

108.00

D.C. Mun. Regs. tit. 29, r. 29-992

Final Rulemaking published at 44 DCR 5495 (September 26, 1997); as amended by Final Rulemaking published at 45 DCR 5224 (August 7, 1998)
Authority: D.C. Official Code § 1-307.02 (2001 ed.); and Reorganization Plan No. 4 of 1996, 3 D.C. Official Code at 413 (2001 ed.).