Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois

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Hcpcs Note ProgCov Eff Date HP NDC Ind SurgInd M1 (26) M2 (TC) Assist Surg Co-Surg Unitprice MaxQty StateMax Surg Child Adult 00906 04 Y M 00908 04 Y M 00910 04 Y M 00912 04 Y M 00914 04 Y M 00916 04 Y M 00918 04 Y M 00920 04 Y M 00921 04 Y M 00922 04 Y M 00924 04 Y M 00926 04 Y M 00928 04 Y M 00930 04 Y M 00932 04 Y M 00934 04 Y M 00936 04 Y M 00938 04 Y M 00940 04 Y I 00942 04 Y M 00944 04 Y M Wednesday, April 01, 2009 Page 8 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 00948 04 Y I 00950 04 Y I 00952 04 Y I 0095T 04 Y M Y 0101T 04 Y M 0102T 04 Y M 01112 04 Y I 01120 04 Y M 01130 04 Y I 01140 04 Y M 01150 04 Y M 01160 04 Y M 01170 04 Y M 01173 04 Y M 01180 04 Y M 01190 04 Y M 01200 04 Y M 01202 04 Y M 01210 04 Y M 01212 04 Y M 01214 04 Y M Wednesday, April 01, 2009 Page 9 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 and 10: Health Care and Family Services Rev
Page 11 and 12: Hcpcs Note ProgCov Eff Date HP NDC
Page 15: Hcpcs Note ProgCov Eff Date HP NDC
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Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois

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