Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois
Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois
Hcpcs Note ProgCov Eff Date HP NDC Ind SurgInd M1 (26) M2 (TC) Assist Surg Co-Surg Unitprice MaxQty StateMax Surg Child Adult 00174 04 Y M 00176 04 Y M 0017T 04 Y M 00190 04 Y M 00192 04 Y M 0019T 04 Y I 00210 04 Y M 00211 04 1/1/2009 Y M 00212 04 Y M 00214 04 Y M 00215 04 Y M 00216 04 Y M 00218 04 Y M 00220 04 Y M 00222 04 Y M 00300 04 Y M 0030T 04 Y N 00320 04 Y M 00322 04 Y M 00326 04 Y M 00350 04 Y M Wednesday, April 01, 2009 Page 2 of 458
Hcpcs Note ProgCov Eff Date HP NDC Ind SurgInd M1 (26) M2 (TC) Assist Surg Co-Surg Unitprice MaxQty StateMax Surg Child Adult 00352 04 Y M 00400 04 Y I 00402 04 Y M 00404 04 Y M 00406 04 Y M 00410 04 N I 112.40 0042T B 04 N N 141.22 141.22 282.45 00450 04 Y M 00452 04 Y M 00454 04 Y I 00470 04 Y M 00472 04 Y M 00474 04 Y M 0048T 04 Y M Y 00500 04 Y M 0051T 04 Y M Y Y 00520 04 Y M 00522 04 Y I 00524 04 Y M 00528 04 Y M 00529 04 Y N Wednesday, April 01, 2009 Page 3 of 458
- Page 1 and 2: Healthcare and Family Services Prac
- Page 3 and 4: Q State maximum amount now includes
- Page 5 and 6: MODIFIERS RECOGNIZED IN PROCESSING
- Page 7 and 8: HO Masters degree level; added 0601
- Page 9: Health Care and Family Services Rev
- Page 13 and 14: Hcpcs Note ProgCov Eff Date HP NDC
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Hcpcs Note ProgCov Eff Date HP NDC Ind SurgInd M1 (26) M2 (TC) Assist Surg Co-Surg Unitprice MaxQty <strong>State</strong>Max Surg Child Adult<br />
0<strong>01</strong>74 <strong>04</strong> Y M<br />
0<strong>01</strong>76 <strong>04</strong> Y M<br />
0<strong>01</strong>7T <strong>04</strong> Y M<br />
0<strong>01</strong>90 <strong>04</strong> Y M<br />
0<strong>01</strong>92 <strong>04</strong> Y M<br />
0<strong>01</strong>9T <strong>04</strong> Y I<br />
00210 <strong>04</strong> Y M<br />
00211 <strong>04</strong> 1/1/20<strong>09</strong> Y M<br />
00212 <strong>04</strong> Y M<br />
00214 <strong>04</strong> Y M<br />
00215 <strong>04</strong> Y M<br />
00216 <strong>04</strong> Y M<br />
00218 <strong>04</strong> Y M<br />
00220 <strong>04</strong> Y M<br />
00222 <strong>04</strong> Y M<br />
00300 <strong>04</strong> Y M<br />
0030T <strong>04</strong> Y N<br />
00320 <strong>04</strong> Y M<br />
00322 <strong>04</strong> Y M<br />
00326 <strong>04</strong> Y M<br />
00350 <strong>04</strong> Y M<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 2 <strong>of</strong> 458
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