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 01852 04 Y M 01860 04 Y M 01916 04 Y I 01920 04 Y M 01922 04 Y I 01924 04 Y M 01925 04 Y M 01926 04 Y I 01930 04 Y M 01931 04 Y M 01932 04 Y M 01933 04 Y M 01935 04 1/1/2008 Y M 01936 04 1/1/2008 Y M 01951 04 Y I 01952 04 Y I 01953 04 Y I 01958 04 Y M 01960 09 Y M 01961 04 Y M 01962 04 Y M Wednesday, April 01, 2009 Page 14 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 01963 04 Y M 01965 04 Y M 01967 04 Y M 01968 04 Y M 01969 04 Y M 01991 04 Y I 01992 04 Y I 01996 04 N I 14.25 01999 04 Y M 0500F 04 N B 44.10 0502F 04 N B 44.10 0503F 04 N B 50.15 10021 04 N I 49.80 10022 04 N I 56.70 10040 04 N I 35.20 10060 04 N I 36.00 10061 04 N I 66.50 10080 04 N I 70.65. 10081 04 N I 131.80 10120 04 N I 39.05 10121 04 N I 77.60 Wednesday, April 01, 2009 Page 15 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
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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 />
<strong>01</strong>963 <strong>04</strong> Y M<br />
<strong>01</strong>965 <strong>04</strong> Y M<br />
<strong>01</strong>967 <strong>04</strong> Y M<br />
<strong>01</strong>968 <strong>04</strong> Y M<br />
<strong>01</strong>969 <strong>04</strong> Y M<br />
<strong>01</strong>991 <strong>04</strong> Y I<br />
<strong>01</strong>992 <strong>04</strong> Y I<br />
<strong>01</strong>996 <strong>04</strong> N I 14.25<br />
<strong>01</strong>999 <strong>04</strong> Y M<br />
0500F <strong>04</strong> N B 44.10<br />
0502F <strong>04</strong> N B 44.10<br />
0503F <strong>04</strong> N B 50.15<br />
10021 <strong>04</strong> N I 49.80<br />
10022 <strong>04</strong> N I 56.70<br />
10<strong>04</strong>0 <strong>04</strong> N I 35.20<br />
10060 <strong>04</strong> N I 36.00<br />
10061 <strong>04</strong> N I 66.50<br />
10080 <strong>04</strong> N I 70.65.<br />
10081 <strong>04</strong> N I 131.80<br />
1<strong>01</strong>20 <strong>04</strong> N I 39.05<br />
1<strong>01</strong>21 <strong>04</strong> N I 77.60<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 15 <strong>of</strong> 458
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