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 84234 B 04 10/1/2008 N N 2.70 2.70 5.40 84235 A 04 10/1/2008 N N 2.70 2.70 5.40 84238 B 04 10/1/2008 N N 10.01 10.01 20.02 84244 A 04 10/1/2008 N N 10.76 10.76 21.52 84252 B 04 10/1/2008 N N 1.31 1.31 2.62 84255 A 04 10/1/2008 N N 2.40 2.40 4.80 84260 A 04 10/1/2008 N N 2.51 2.51 5.02 84270 B 04 10/1/2008 N N 8.19 8.19 16.38 84275 A 04 10/1/2008 N N 1.76 1.76 3.52 84285 A 04 10/1/2008 N N 1.80 1.80 3.60 84295 A 04 10/1/2008 N N 2.33 2.33 4.66 84300 A 04 10/1/2008 N N 2.12 2.12 4.24 84302 B 04 10/1/2008 N N 1.28 1.28 2.56 84305 B 04 10/1/2008 N N 7.54 7.54 15.08 84307 B 04 10/1/2008 N N 7.54 7.54 15.08 84311 A 04 10/1/2008 N N 3.44 3.44 6.88 84315 A 04 10/1/2008 N N 1.22 1.22 2.44 84375 A 04 10/1/2008 N N 2.33 2.33 4.66 84376 A 04 10/1/2008 N N 2.70 2.70 5.40 84377 A 04 10/1/2008 N N 2.70 2.70 5.40 84378 A 04 10/1/2008 N N 2.96 2.96 5.92 Wednesday, April 01, 2009 Page 330 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 84379 A 04 10/1/2008 N N 2.96 2.96 5.92 84392 A 04 10/1/2008 N N 2.33 2.33 4.66 84402 A 04 10/1/2008 N N 9.17 9.17 18.34 84403 A 04 10/1/2008 N N 12.64 12.64 25.28 84425 B 04 10/1/2008 N N 6.41 6.41 12.82 84430 B 04 10/1/2008 N N 3.58 3.58 7.16 84432 B 04 10/1/2008 N N 7.86 7.86 15.72 84436 B 04 10/1/2008 N N 3.36 3.36 6.72 84437 B 04 10/1/2008 N N 3.19 3.19 6.38 84439 B 04 10/1/2008 N N 4.43 4.43 8.86 84442 B 04 10/1/2008 N N 4.43 4.43 8.86 84443 B 04 10/1/2008 N N 8.21 8.21 16.42 84445 B 04 10/1/2008 N N 13.48 13.48 26.96 84446 B 04 10/1/2008 N N 4.43 4.43 8.86 84449 04 10/1/2008 N N 6.71 6.71 13.42 84450 A 04 10/1/2008 N N 2.51 2.51 5.02 84460 A 04 10/1/2008 N N 2.59 2.59 5.18 84466 A 04 10/1/2008 N N 4.39 4.39 8.78 84478 B 04 10/1/2008 N N 2.70 2.70 5.40 84479 B 04 10/1/2008 N N 3.19 3.19 6.38 84480 B 04 10/1/2008 N N 4.78 4.78 9.56 Wednesday, April 01, 2009 Page 331 of 458
- Page 287 and 288: Hcpcs Note ProgCov Eff Date HP NDC
- Page 289 and 290: Hcpcs Note ProgCov Eff Date HP NDC
- Page 291 and 292: Hcpcs Note ProgCov Eff Date HP NDC
- Page 293 and 294: Hcpcs Note ProgCov Eff Date HP NDC
- Page 295 and 296: Hcpcs Note ProgCov Eff Date HP NDC
- Page 297 and 298: Hcpcs Note ProgCov Eff Date HP NDC
- Page 299 and 300: Hcpcs Note ProgCov Eff Date HP NDC
- Page 301 and 302: Hcpcs Note ProgCov Eff Date HP NDC
- Page 303 and 304: Hcpcs Note ProgCov Eff Date HP NDC
- Page 305 and 306: Hcpcs Note ProgCov Eff Date HP NDC
- Page 307 and 308: Hcpcs Note ProgCov Eff Date HP NDC
- Page 309 and 310: Hcpcs Note ProgCov Eff Date HP NDC
- Page 311 and 312: Hcpcs Note ProgCov Eff Date HP NDC
- Page 313 and 314: Hcpcs Note ProgCov Eff Date HP NDC
- Page 315 and 316: Hcpcs Note ProgCov Eff Date HP NDC
- Page 317 and 318: Hcpcs Note ProgCov Eff Date HP NDC
- Page 319 and 320: Hcpcs Note ProgCov Eff Date HP NDC
- Page 321 and 322: Hcpcs Note ProgCov Eff Date HP NDC
- Page 323 and 324: Hcpcs Note ProgCov Eff Date HP NDC
- Page 325 and 326: Hcpcs Note ProgCov Eff Date HP NDC
- Page 327 and 328: Hcpcs Note ProgCov Eff Date HP NDC
- Page 329 and 330: Hcpcs Note ProgCov Eff Date HP NDC
- Page 331 and 332: Hcpcs Note ProgCov Eff Date HP NDC
- Page 333 and 334: Hcpcs Note ProgCov Eff Date HP NDC
- Page 335 and 336: Hcpcs Note ProgCov Eff Date HP NDC
- Page 337: Hcpcs Note ProgCov Eff Date HP NDC
- Page 341 and 342: Hcpcs Note ProgCov Eff Date HP NDC
- Page 343 and 344: Hcpcs Note ProgCov Eff Date HP NDC
- Page 345 and 346: Hcpcs Note ProgCov Eff Date HP NDC
- Page 347 and 348: Hcpcs Note ProgCov Eff Date HP NDC
- Page 349 and 350: Hcpcs Note ProgCov Eff Date HP NDC
- Page 351 and 352: Hcpcs Note ProgCov Eff Date HP NDC
- Page 353 and 354: Hcpcs Note ProgCov Eff Date HP NDC
- Page 355 and 356: Hcpcs Note ProgCov Eff Date HP NDC
- Page 357 and 358: Hcpcs Note ProgCov Eff Date HP NDC
- Page 359 and 360: Hcpcs Note ProgCov Eff Date HP NDC
- Page 361 and 362: Hcpcs Note ProgCov Eff Date HP NDC
- Page 363 and 364: Hcpcs Note ProgCov Eff Date HP NDC
- Page 365 and 366: Hcpcs Note ProgCov Eff Date HP NDC
- Page 367 and 368: Hcpcs Note ProgCov Eff Date HP NDC
- Page 369 and 370: Hcpcs Note ProgCov Eff Date HP NDC
- Page 371 and 372: Hcpcs Note ProgCov Eff Date HP NDC
- Page 373 and 374: Hcpcs Note ProgCov Eff Date HP NDC
- Page 375 and 376: Hcpcs Note ProgCov Eff Date HP NDC
- Page 377 and 378: Hcpcs Note ProgCov Eff Date HP NDC
- Page 379 and 380: Hcpcs Note ProgCov Eff Date HP NDC
- Page 381 and 382: Hcpcs Note ProgCov Eff Date HP NDC
- Page 383 and 384: Hcpcs Note ProgCov Eff Date HP NDC
- Page 385 and 386: Hcpcs Note ProgCov Eff Date HP NDC
- Page 387 and 388: Hcpcs Note ProgCov Eff Date HP NDC
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 />
84234 B <strong>04</strong> 10/1/2008 N N 2.70 2.70 5.40<br />
84235 A <strong>04</strong> 10/1/2008 N N 2.70 2.70 5.40<br />
84238 B <strong>04</strong> 10/1/2008 N N 10.<strong>01</strong> 10.<strong>01</strong> 20.02<br />
84244 A <strong>04</strong> 10/1/2008 N N 10.76 10.76 21.52<br />
84252 B <strong>04</strong> 10/1/2008 N N 1.31 1.31 2.62<br />
84255 A <strong>04</strong> 10/1/2008 N N 2.40 2.40 4.80<br />
84260 A <strong>04</strong> 10/1/2008 N N 2.51 2.51 5.02<br />
84270 B <strong>04</strong> 10/1/2008 N N 8.19 8.19 16.38<br />
84275 A <strong>04</strong> 10/1/2008 N N 1.76 1.76 3.52<br />
84285 A <strong>04</strong> 10/1/2008 N N 1.80 1.80 3.60<br />
84295 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />
84300 A <strong>04</strong> 10/1/2008 N N 2.12 2.12 4.24<br />
84302 B <strong>04</strong> 10/1/2008 N N 1.28 1.28 2.56<br />
84305 B <strong>04</strong> 10/1/2008 N N 7.54 7.54 15.08<br />
84307 B <strong>04</strong> 10/1/2008 N N 7.54 7.54 15.08<br />
84311 A <strong>04</strong> 10/1/2008 N N 3.44 3.44 6.88<br />
84315 A <strong>04</strong> 10/1/2008 N N 1.22 1.22 2.44<br />
84375 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />
84376 A <strong>04</strong> 10/1/2008 N N 2.70 2.70 5.40<br />
84377 A <strong>04</strong> 10/1/2008 N N 2.70 2.70 5.40<br />
84378 A <strong>04</strong> 10/1/2008 N N 2.96 2.96 5.92<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 330 <strong>of</strong> 458
Change language