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Rule 59G-4.002, Provider Reimbursement Schedules and Billing Codes

Fee Schedule Effective Date
Ambulatory Surgical Center Services Fee Schedule Promulgated Fee Schedule 7/1/2018
Promulgated XLS 7/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Assistive Care Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Behavior Analysis Fee Schedule Promulgated Fee Schedule 1/1/2018
Behavioral Health Overlay Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Birth Center Fee Schedule Promulgated Fee Schedule 7/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Child Health Targeted Case Management Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Community-Based Substance Abuse County Match Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Community Behavioral Health Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
County Health Department Certified Match Program Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Dental General Fee Schedule Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients Promulgated Fee Schedule 7/1/2018
Promulgated XLS 7/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Early Intervention Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Hearing Services Fee Schedule

Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019

Home Health Visit Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Immunization Fee Schedule (Proposed name change to "Prescribed Drug Immunization Fee Schedule" effective 2019) Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Independent Laboratory Fee Schedule Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Injectable Medicaitions Oncology Fee Schedule (Proposed name change to "Prescribed Drugs Oncology Physician Administred Fee Schedule" effective 2019) Fee Schedule 1/1/2018
XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Licensed Midwife Fee Schedule Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Medicaid Certified School Match Program Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Medical Foster Care Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Mental Health Targeted Case Management Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Occupational Therapy Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Outpatient Laboratory Fee Schedule
(Formerly titled Physician and Outpatient Laboratory Fee Schedule)
Promulgated Fee Schedule 7/1/2018
Promulgated XLS 7/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Personal Care Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Physical Therapy Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Physician Pediatric Surgery Fee Schedule Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Practitioner Fee Schedule Promulgated Fee Schedule 7/1/2018
Promulgated XLS 7/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Practitioner Laboratory Fee Schedule
(Formerly titled Physician and Outpatient Laboratory Fee Schedule)
Promulgated Fee Schedule 7/1/2018
Promulgated XLS 7/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Prescribed Drugs Physician Administered Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Prescribed Pediatric Extended Care Services Fee Schedule Promulgated Fee Schedule 1/1/2018
Updated Fee Schedule 7/1/2018

Updated Fee Schedule 2019
Private Duty Nursing Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Radiology Fee Schedule Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019
Respiratory Therapy Services Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Specialized Therapeutic Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Speech-Language Pathology Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Transportation Services Fee Schedule Promulgated Fee Schedule 1/1/2018

Updated Fee Schedule 2019
Visual Services Fee Schedule Promulgated Fee Schedule 1/1/2018
Promulgated XLS 1/1/2018

Updated Fee Schedule 2019
Updated XLS 2019

Billing Code Effective Date
County Health Department Billing Codes Promulgated Billing Code 1/1/2018

Updated Billing Code 2019
Federally Qualified Health Center Billing Codes Promulgated Billing Code 1/1/2018

Updated Billing Code 2019
Hospice Services Billing Codes Promulgated Billing Code 7/1/2018

Updated Billing Code 2019
Hospital Outpatient Services Billing Codes Promulgated Billing Code 7/1/2018

Updated Billing Code 2019
Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes Promulgated Billing Code 1/1/2018

Updated Billing Code 2019
Nursing Facility Services Billing Codes Promulgated Billing Code 1/1/2018

Updated Billing Code 2019
Rural Health Clinic Billing Codes Promulgated Billing Code 1/1/2018

Updated Billing Code 2019
Statewide Inpatient Psychiatric Program Services Billing Codes Promulgated Billing Code 1/1/2018

Updated Billing Code 2019