Podiatry Fee Schedule Key - Illinois Department of Healthcare and ...
Podiatry Fee Schedule Key - Illinois Department of Healthcare and ... Podiatry Fee Schedule Key - Illinois Department of Healthcare and ...
Prior Prog Hand NDC HCPCS Approv Cov EffectiveDt Price Ind Surg Ind AsstSurg State Max 29700 04 I 24.15 29730 04 I 36.00 29740 04 I 46.55 29750 04 I 44.30 29799 04 Y I 29891 04 07/01/2008 M Y 480.00 29892 04 07/01/2008 M Y 480.00 29893 04 07/01/2008 M 171.90 29894 04 02/01/2006 M 480.00 29895 04 07/01/2008 M Y 480.00 29897 04 07/01/2008 M 480.00 29898 04 02/01/2006 M Y 480.00 29899 04 07/01/2008 M Y 659.00 64455 04 01/01/2009 N 38.95 64632 04 01/01/2009 N 90.50 64704 04 01/01/2009 N 90.50 73600 04 N 21.50 73610 04 N 28.70 73620 04 N 17.00 73630 04 N 21.50 73650 04 N 17.00 73660 04 N 14.35 76499 04 Y N 81000 04 N 3.50 82947 04 N 5.10 84550 04 N 5.90 85002 04 N 2.30 85014 04 N 3.10 85345 04 N 4.00 85610 04 N 5.10 85651 04 N 4.60 85652 04 N 3.50 87101 04 N 6.20 87220 04 N 4.70 90703 04 N N 1.85 97597 04 01/01/2011 Y N 97598 04 01/01/2011 Y N 99070 04 Y 99199 Y 04 Y M 99201 04 10/01/2009 N 27.95 99202 04 10/01/2009 N 32.00 99203 04 10/01/2009 N 41.60 99204 04 10/01/2009 N 66.40
Prior Prog Hand NDC HCPCS Approv Cov EffectiveDt Price Ind Surg Ind AsstSurg State Max 99205 04 10/01/2009 N 70.85 99211 04 10/01/2009 N 12.30 99212 04 10/01/2009 N 24.25 99213 04 10/01/2009 N 28.35 99214 04 10/01/2009 N 42.50 99215 04 10/01/2009 N 48.00 99231 04 10/01/2009 N 16.40 99232 04 10/01/2009 N 24.90 99233 04 10/01/2009 N 35.05 99241 04 10/01/2009 N 32.15 99242 04 10/01/2009 N 40.20 99243 04 10/01/2009 N 51.30 99244 04 10/01/2009 N 71.40 99245 04 10/01/2009 N 92.80 99251 04 10/01/2009 N 32.15 99252 04 10/01/2009 N 33.95 99253 04 10/01/2009 N 46.45 99254 04 10/01/2009 N 66.40 99255 04 10/01/2009 N 87.10 99281 04 10/01/2009 N 14.35 99282 04 10/01/2009 N 24.20 99283 04 10/01/2009 N 32.20 99284 04 10/01/2009 N 44.00 99285 04 07/01/2008 N 69.25 99307 04 01/01/2006 N 14.80 99308 04 07/01/2008 N 18.91 99309 04 07/01/2008 N 23.40 99310 04 07/01/2008 N 32.05 99324 04 02/01/2010 N 18.60 99325 04 02/01/2010 N 26.70 99326 04 02/01/2010 N 34.85 99327 04 02/01/2010 N 42.95 99328 04 02/01/2010 N 51.05 99334 04 02/01/2010 N 16.00 99335 04 02/01/2010 N 21.00 99336 04 02/01/2010 N 26.05 99337 04 02/01/2010 N 31.05 99341 04 N 27.95 99342 04 04/01/2010 N 37.40 99343 04 04/01/2010 N 54.90 99344 04 04/01/2010 N 70.55 99345 04 04/01/2010 N 85.55 99347 04 N 24.25
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Prior Prog<br />
H<strong>and</strong> NDC<br />
HCPCS Approv Cov EffectiveDt Price Ind Surg Ind AsstSurg State Max<br />
29700 04 I 24.15<br />
29730 04 I 36.00<br />
29740 04 I 46.55<br />
29750 04 I 44.30<br />
29799 04 Y I<br />
29891 04 07/01/2008 M Y 480.00<br />
29892 04 07/01/2008 M Y 480.00<br />
29893 04 07/01/2008 M 171.90<br />
29894 04 02/01/2006 M 480.00<br />
29895 04 07/01/2008 M Y 480.00<br />
29897 04 07/01/2008 M 480.00<br />
29898 04 02/01/2006 M Y 480.00<br />
29899 04 07/01/2008 M Y 659.00<br />
64455 04 01/01/2009 N 38.95<br />
64632 04 01/01/2009 N 90.50<br />
64704 04 01/01/2009 N 90.50<br />
73600 04 N 21.50<br />
73610 04 N 28.70<br />
73620 04 N 17.00<br />
73630 04 N 21.50<br />
73650 04 N 17.00<br />
73660 04 N 14.35<br />
76499 04 Y N<br />
81000 04 N 3.50<br />
82947 04 N 5.10<br />
84550 04 N 5.90<br />
85002 04 N 2.30<br />
85014 04 N 3.10<br />
85345 04 N 4.00<br />
85610 04 N 5.10<br />
85651 04 N 4.60<br />
85652 04 N 3.50<br />
87101 04 N 6.20<br />
87220 04 N 4.70<br />
90703 04 N N 1.85<br />
97597 04 01/01/2011 Y N<br />
97598 04 01/01/2011 Y N<br />
99070 04 Y<br />
99199 Y 04 Y M<br />
99201 04 10/01/2009 N 27.95<br />
99202 04 10/01/2009 N 32.00<br />
99203 04 10/01/2009 N 41.60<br />
99204 04 10/01/2009 N 66.40
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