Wisconsin

high

Max Fee Download

SUCCESS

Run Date and Time

Oct 15, 2026

1m 49s

Run Metrics

New48
Changed0
Unchanged0
Checked48

Fee Schedule Impacts

High11
Medium17
Low20

Run summary

This run for Wisconsin ForwardHealth Max Fee / max-fee-download identified 0 changed documents and 48 newly discovered documents. 11 item(s) are high priority. 2 newly discovered item(s) appear current or upcoming.

High Impact (11)

DME_max_fee_20261003.txt

high

The document includes updates to Medicaid rates for durable medical equipment, with specific rates and effective dates provided for several items, including codes 94762, 94772, A4210, K0854, and K0855. Notably, K0855 has a new rate effective January 1, 2024.

Highlights

  • •Code 94762: Rate $41.75, effective 2008-07-01.
  • •Code 94772: Rate $126.57, effective 2008-07-01.
  • •Code A4210: Rate $492.57, effective 2008-07-01.
  • •Code K0854: Rate $9670.40, effective 2022-02-01.
  • •Code K0855: New rate $10707.60, effective 2024-01-01.

Reason

The document includes a new rate for code K0855 effective January 1, 2024, which is imminent and impacts reimbursement.

Watch items

K0855 effective 2024-01-01K0854 effective 2022-02-0194762 rate $41.7594772 rate $126.57A4210 rate $492.57

CHIRO_max_fee_20261003.txt

high

The document outlines new Medicaid reimbursement rates for chiropractic services, effective January 1, 2024, with specific CPT codes and maximum fees listed.

Highlights

  • •New rates effective January 1, 2024.
  • •CPT codes include 72040, 72050, 72052, 72070, 73070, 73080.
  • •Rates range from $22.49 to $61.56.
  • •Applies to chiropractic services.

Reason

The document includes specific rate changes effective soon, impacting reimbursements.

Watch items

7204072050720527307073080

LAB_max_fee_20261003.txt

high

The document contains updates to Medicaid reimbursement rates for various medical laboratory services, including specific CPT codes and their associated fees. Notably, a new rate for code 0464u is set to become effective on July 1, 2025.

Highlights

  • •New rate for CPT code 0464u effective 2025-07-01.
  • •Rates for CPT codes 80047, 80048, 80050, 86231, 86235, and 86255 included.
  • •CPT code 0464u has a max fee of 473.54.
  • •CPT code 80047 has a max fee of 11.51.
  • •CPT code 86231 has a max fee of 12.05.

Reason

The document includes a new rate effective soon, impacting reimbursement.

Watch items

0464u20250701800478004886231

AMBUL_max_fee_20261003.txt

high

The document outlines updates to ambulance transport rates, including specific rate changes and effective dates for codes 90480 and 90611, with future effective dates extending to 2299.

Highlights

  • •Rate for code 90480 changes to $44.95 effective 2025-10-01.
  • •Rate for code 90611 changes to $260.13 effective 2026-08-01.
  • •Rates are effective until 2299-12-31.

Reason

The document includes specific rate changes with future effective dates, impacting reimbursement.

Watch items

90480906112025-10-012026-08-01

MHIHP_max_fee_20261003.txt

high

The document introduces new Medicaid rates for mental health services, effective from August 1, 2024, to December 31, 2299. It includes specific CPT codes and maximum fees for various service modifiers.

Highlights

  • •New rates for mental health services in home psychology (CPT 99199, H0004, H0022).
  • •Effective date: August 1, 2024.
  • •Rates vary by service modifier (e.g., 'hn' $15.01, 'ho' $22.51).
  • •Applies to multiple service locations and codes.

Reason

The document specifies new reimbursement rates effective soon, impacting billing and reimbursement.

Watch items

CPT 99199CPT H0004CPT H0022Effective date: 20240801

MHNTS_max_fee_20261003.txt

high

The document outlines Medicaid rate updates for mental health and narcotic treatment services, including specific CPT codes and their associated fees. Notably, a new rate for code 81025 is effective from January 1, 2024.

Highlights

  • •New rate for code 81025 effective 2024-01-01.
  • •Rates for codes 86580, 99001, and H0020 are listed.
  • •Multiple modifiers and fee structures are detailed.
  • •Effective dates range from 2008 to 2026.

Reason

The document includes a new rate effective soon, impacting reimbursement.

Watch items

810258658099001H002020240101

DTAOD_max_fee_20261003.txt

high

The document outlines Medicaid rate updates for day treatment services, including specific CPT/HCPCS codes and maximum fees. Notably, there are changes effective from July 1, 2023, and future rates set for 2026.

Highlights

  • •New rate for code 80305 effective July 1, 2023.
  • •Rates for code H2012 with modifiers effective January 1, 2026.
  • •Maximum fee for code 80305 is $12.60.
  • •Maximum fee for code H2012 with modifiers is $35.60.

Reason

The document includes reimbursement-impacting changes effective now and in the near future.

Watch items

80305H20122023070120260101

HCRS_max_fee_20261003.txt

high

The document outlines Medicaid rate updates for home care-resp care services under code 99504, with new rates effective from January 1, 2026.

Highlights

  • •New rates for code 99504 effective January 1, 2026.
  • •Rates include maxfee adjustments with modifiers 'td' and 'te'.
  • •Current rates valid until December 31, 2025.

Reason

The document includes specific rate changes effective soon, impacting reimbursement.

Watch items

9950420260101maxfeetdte

MIDWF_max_fee_20261003.txt

high

The document introduces new Medicaid reimbursement rates for licensed midwives, effective January 1, 2024. It includes specific CPT codes with associated maximum fees and geographic modifiers.

Highlights

  • •New rates for licensed midwives effective 2024.
  • •CPT codes 36415, 36416, 59025, 59400, 99204 included.
  • •Maximum fees specified for each code.
  • •Geographic and age-related modifiers applied.

Reason

The document contains new reimbursement rates effective soon, impacting billing and policy.

Watch items

3641536416590255940099204

behav_max_fee_20261003.txt

high

The document outlines updated Medicaid rates for behavioral treatment services, including specific CPT codes and maximum fees effective from 2023.

Highlights

  • •CPT 97151: Max fee $25.90, effective 2023-02-01
  • •CPT 97152: Max fee $22.93, effective 2023-02-01
  • •CPT 97154: Various max fees, effective 2022-12-01

Reason

The document includes specific rate changes for behavioral treatment services effective in 2023, impacting reimbursement.

Watch items

CPT 97151CPT 97152CPT 97154Effective date 2023-02-01Effective date 2022-12-01

PNCCC_max_fee_20261003.txt

high

The document introduces new Medicaid rates for child care coordination services with effective dates starting February 1, 2023, and ending December 31, 2299. Rates for various codes such as H1000, H1002, H1003, H1004, and T1016 are specified.

Highlights

  • •New rates for child care coordination services.
  • •Effective from February 1, 2023, to December 31, 2299.
  • •Includes codes H1000, H1002, H1003, H1004, T1016.
  • •Rates range from $11.35 to $90.80.

Reason

The document specifies new rates and effective dates for Medicaid services, impacting reimbursement.

Watch items

H1000H1002H1003H1004T1016
Medium Impact (17)

MISC_max_fee_20261003.txt

medium

The document includes updates to Medicaid rates for specific codes, with effective dates ranging from 2021 to 2026. Notable changes include the introduction of new maximum fees for codes 0373T, 19300, and 64567.

Highlights

  • •Code 0373T has a max fee of 18.34 effective from 2021.
  • •Code 19300 has multiple entries with fees of 389.42 and 350.48, effective from 2017.
  • •Code 64567 has a max fee of 953.60 effective from 2026.

Reason

The document contains rate updates, but the effective dates are not imminent, reducing urgency.

Watch items

0373T19300645672021010120260701

HHPC_max_fee_20261003.txt

medium

The document outlines Medicaid rate updates for home care services, including specific CPT codes and maximum fees, with effective dates ranging from 2022 to 2026.

Highlights

  • •CPT code 92507 has a max fee of $98.19 and $90.96, effective 2022.
  • •CPT code 97139 has a max fee of $95.11 and $88.11, effective 2022.
  • •CPT code 99600 has a future rate of $117.86, effective 2026.
  • •CPT code s9123 has a future rate of $67.55, effective 2026.
  • •CPT code s9124 has a future rate of $55.00, effective 2026.

Reason

The document includes future rate changes effective in 2026, but no immediate changes.

Watch items

CPT 99600 effective 2026CPT s9123 effective 2026CPT s9124 effective 2026

HOSPC_max_fee_20261003.txt

medium

The document contains new Medicaid rate updates for hospice services, specifically for codes G0155 and T2042, effective from October 1, 2025, to December 31, 2299.

Highlights

  • •New rates for hospice code G0155 effective 2025-10-01.
  • •New rates for hospice code T2042 effective 2025-10-01.
  • •Rates are valid until 2299-12-31.

Reason

The changes are relevant but not urgent as they are effective in 2025.

Watch items

G0155T204220251001

MHAOD_max_fee_20261003.txt

medium

The document includes Medicaid rate updates for mental health services, specifically for CPT codes 80305 and 90785, with effective dates ranging from 20220101 to 22991231. Rates for these services are specified, such as a max fee of 12.60 for code 80305 starting 20230701.

Highlights

  • •CPT code 80305 has a max fee of 12.60 effective 20230701.
  • •CPT code 90785 has a max fee of 12.43 effective 20220101.
  • •Effective dates range from 20220101 to 22991231.

Reason

The document contains specific rate updates, but the effective dates are not imminent, reducing urgency.

Watch items

80305907852023070120220101

WWWP_max_fee_20261003.txt

medium

The document outlines new maximum fee schedules for the Wisconsin Well Woman Program, with effective dates ranging from 2024 to 2026.

Highlights

  • •New fee schedule for Wisconsin Well Woman Program.
  • •Effective dates range from 2024 to 2026.
  • •Includes specific CPT codes with associated fees.

Reason

The changes are relevant but not immediately effective, with future dates starting in 2024.

Watch items

CPT 00400 effective 2024-07-01CPT 00940 effective 2024-07-01CPT 10004 effective 2026-07-01CPT 81515 effective 2025-01-01

HCMCR_max_fee_20261003.txt

medium

The document introduces new Medicaid rates for high-cost medical complexity services, with specific codes and maximum fees listed.

Highlights

  • •New rates for 'high cost med complx' services.
  • •Codes G0506 and T2023 are included.
  • •Maximum fees are $1201.41 and $434.24 respectively.
  • •Effective from 20220101 to 22991231.

Reason

The document contains specific rate changes but the effective date is not imminent.

Watch items

G0506T20231201.41434.2420220101

AUDHA_max_fee_20261003.txt

medium

The document provides updated Medicaid rates for hearing services, including specific CPT codes and maximum fees effective from 2022 to 2299.

Highlights

  • •CPT 69210: Max fee $35.35
  • •CPT 92502: Max fee $122.22
  • •CPT 92504: Max fee $24.10
  • •CPT 92653: Max fee $66.21
  • •CPT V5014: Max fee $154.11

Reason

The document contains updated rates for specific CPT codes, but the effective dates are not imminent, reducing urgency.

Watch items

69210925029250492653V5014

AMBSR_max_fee_20261003.txt

medium

The document contains Medicaid rate updates for ambulatory surgical centers with effective dates ranging from 2019 to 2026. Rates for specific codes are provided, with some changes effective in 2026.

Highlights

  • •Rates for codes 10005, 10007, 10009, 10011, 10021, 10030, 10035, 10036, 10040 effective from 2019.
  • •Rates for codes 37259 to 37266 effective from 2026.
  • •Rates range from $106.18 to $1097.28.
  • •Effective dates span from 2019 to 2026.

Reason

The document includes future rate changes effective in 2026, but no immediate changes.

Watch items

1000510007100213725937266

MHCI_max_fee_20261003.txt

medium

The document includes updates to Medicaid rates for mental health crisis intervention services, specifically for CPT codes 99281 and H2011, with effective dates from 2022 and 2023 extending to 2299. Rates vary based on modifiers such as 'hn', 'ho', 'hp', 'u7', 'ua', and 'u8'.

Highlights

  • •CPT code 99281 rates updated with modifiers 'hn', 'ho', 'hp', 'u7', 'ua'.
  • •CPT code H2011 rates updated with modifiers 'u8', 'ua'.
  • •Effective dates range from 20220901 to 22991231.
  • •Rates for 99281 range from $47.42 to $148.16.
  • •Rates for H2011 are $13.97 and $37.04.

Reason

The document contains current rate updates but lacks immediate effective changes.

Watch items

99281H2011202209012023010122991231

THERP_max_fee_20261003.txt

medium

The document contains updated Medicaid reimbursement rates for therapy services, including occupational, physical, and speech therapy, with effective dates from January 1, 2022, to December 31, 2299. Rates for specific codes such as 29065, 29075, and 97116 are provided.

Highlights

  • •Updated rates for therapy services (OT/PT/Speech).
  • •Effective dates: January 1, 2022, to December 31, 2299.
  • •Codes include 29065, 29075, 97116.
  • •Rates: 29065 at $77.13, 29075 at $53.73, 97116 at $21.29.

Reason

The document provides updated rates but the effective date is not imminent.

Watch items

2906529075971162022010122991231

ASTSG_max_fee_20261003.txt

medium

The document contains Medicaid rate updates for specific CPT codes with effective dates from 2022 to 2299. Rates for codes 12018, 12047, 12057, 35276, and 35281 are specified with different fee structures.

Highlights

  • •CPT code 12018: Rates of $57.90 and $51.60 effective from 2022.
  • •CPT code 12047: Rates of $54.80 and $49.32 effective from 2022.
  • •CPT code 12057: Rate of $107.74 effective from 2022.
  • •CPT code 35276: Rates of $296.48 and $266.83 effective from 2008.
  • •CPT code 35281: Rates of $210.24 and $189.21 effective from 2008.

Reason

The document includes specific rate updates, but the effective dates are not imminent, reducing urgency.

Watch items

1201812047120573527635281

CSMGT_max_fee_20261003.txt

medium

The document outlines new Medicaid case management rates for various codes, including G9012, H0001, H0006, and T1017, with effective dates ranging from 2022 to 2023.

Highlights

  • •New rates for G9012, H0001, H0006, and T1017.
  • •Effective dates from 20220101 to 22991231.
  • •Rates include $408.70 for H0001 and $11.98 for T1017.
  • •Multiple modifiers and fee schedules are specified.

Reason

The document contains new rate information but lacks imminent effective dates or major policy changes.

Watch items

G9012H0001H0006T1017Effective dates: 20220101, 20230201

DMS_max_fee_20261003.txt

medium

The document includes updates to Medicaid rates for specific supply codes, with effective dates ranging from 2004 to 2024. Notably, code A4544 has a new rate effective October 1, 2024.

Highlights

  • •Code A4206: Rate $0.22, effective 2004-01-01 to 2299-12-31
  • •Code A4207: Rate $0.18, effective 2004-01-01 to 2299-12-31
  • •Code A4208: Rate $0.17, effective 2004-01-01 to 2299-12-31
  • •Code A4544: New rate $5.07, effective 2024-10-01 to 2299-12-31
  • •Code A4550: Rate $7.25, effective 2008-07-01 to 2299-12-31

Reason

The document includes a future rate change for code A4544, but most rates are historical or long-term.

Watch items

A4544 effective 2024-10-01A4206A4207A4208A4550

SPEC_max_fee_20261003.txt

medium

The document outlines new Medicaid reimbursement rates for state-purchased eyeglasses, effective from September 1, 2025, to December 31, 2299. Several specific codes, such as v2020, v2100, and v2299, have updated maximum fees.

Highlights

  • •New rates for eyeglass codes v2020, v2100, v2101, v2102, v2219, v2220, v2221, v2299, v2300, and v2301.
  • •Effective date for changes: September 1, 2025.
  • •Rates valid until December 31, 2299.
  • •Maximum fees range from $4.20 to $105.00.

Reason

The changes are not effective immediately but are relevant for future planning.

Watch items

v2020v2100v229920250901maxfee

C4K_max_fee_20261003.txt

medium

The document introduces a new Medicaid rate entry for the "care4kids" program with a specific code and fee details.

Highlights

  • •New entry for "care4kids" program.
  • •Code: T1016.
  • •Max fee: 16.70.
  • •Effective date: 20220101 to 22991231.

Reason

The document includes a new rate entry, but the effective date is not imminent.

Watch items

T101616.702022010122991231

WCDH_max_fee_20261003.txt

medium

The document outlines new Medicaid reimbursement rates for hemophilia home care services, effective from July 1, 2026, with specific rates listed for various HCPCS codes.

Highlights

  • •New rates for HCPCS codes J7187, J7188, J7190, J7192, J7193, J7194, J7195, J7197, J7198.
  • •Effective dates range from July 1, 2026, to December 31, 2299.
  • •Rates vary slightly over different periods, indicating scheduled updates.

Reason

The changes are relevant but not urgent as they are effective in 2026.

Watch items

J7187J7188J7190J7192J7193

SBS_max_fee_20261003.txt

medium

The document outlines new Medicaid rates for school-based services, effective from August 11, 2025, to September 30, 2026, with subsequent rates effective from October 1, 2026, to December 31, 2299. Rates for services such as 90846, 90847, 92507, and 99202 are specified.

Highlights

  • •New rates for CPT 90846 and 90847 effective from 20250811 to 20260930 and from 20261001 onward.
  • •CPT 92507 rate effective from 20040101 to 22991231.
  • •CPT 99202 and 99203 rates specified for two periods: 20250811 to 20260930 and from 20261001 onward.

Reason

The changes are not immediately effective but will impact future reimbursement rates.

Watch items

CPT 90846CPT 90847CPT 92507CPT 99202CPT 99203
Low Impact (20)

DTCHD_max_fee_20261003.txt

low

The document introduces a new entry for 'day treatment-child' with code H2012, effective from January 1, 2022, to December 31, 2299, with a maximum fee of 39.04.

Highlights

  • •New entry for 'day treatment-child' with code H2012.
  • •Effective date: January 1, 2022, to December 31, 2299.
  • •Maximum fee set at 39.04.

Reason

The effective date is historical, starting in 2022, and does not indicate a new or urgent change.

Watch items

H2012202201012299123139.04

WCDC_max_fee_20261003.txt

low

The document provides rate information for anesthesia and lab services related to adult cystic fibrosis, with effective dates ranging from 2006 to 2020 and extending to 2299.

Highlights

  • •Rates for anesthesia services (CPT 00160, 00520) with modifiers qk, qx, qy, qz.
  • •Rates for lab services (CPT 85049, 85610, 85651) with effective dates from 2020.
  • •Effective dates range from 20061001 to 22991231.

Reason

The document appears to contain historical rates with no immediate changes or updates impacting current reimbursement.

DENTL_max_fee_20261003.txt

low

The document contains dental Medicaid rate information with specific codes and maximum fees, effective from 20220101 to 22991231. Rates for codes 10120 and d1351 are specified, with no immediate changes indicated.

Highlights

  • •Dental code 10120 has a max fee of 46.45.
  • •Dental code d1351 has a max fee of 24.02.
  • •Effective date range is 20220101 to 22991231.

Reason

The document appears to be archival with no new changes or updates impacting current reimbursement rates.

CCO_max_fee_20261003.txt

low

The document lists rates for the code G9002 under 'community care org' with effective dates from 2009 to 2299, indicating it is archival.

Highlights

  • •Code: G9002
  • •Rates: $13.50, $83.28, $20.45
  • •Effective dates: 20090101 to 22991231

Reason

The effective dates are far in the past and extend far into the future, indicating archival status.

Watch items

G9002

WCDK_max_fee_20261003.txt

low

The document contains rate information for anesthesia services related to renal disease, with specific codes and rates listed. The effective dates range from 2006 to 2299, indicating these are not immediate changes.

Highlights

  • •Rates for anesthesia services related to renal disease.
  • •Codes include 00532, 00840, 86911, 86920, 86921, 86922, 86927, 86930.
  • •Effective dates from 20061001 to 22991231.
  • •Rates vary by modifier (e.g., qk, qx, qy, qz).

Reason

The effective dates are far in the past and extend far into the future, indicating no immediate urgency.

RDLGY_max_fee_20261003.txt

low

The document contains Medicaid rate information for medical radiology services, including CPT codes 70010, 76776, and 76800, with specified maximum fees and modifiers. The effective dates range from 2008 to 2299, indicating these are not immediate changes.

Highlights

  • •CPT code 70010 with various modifiers and fees.
  • •CPT code 76776 with fees effective from 2008.
  • •CPT code 76800 with fees effective from 2008.

Reason

The document appears to be archival with effective dates far in the past, not indicating urgent changes.

HCCM_max_fee_20261003.txt

low

The document introduces new Medicaid rates for healthcare case management services, specifically for codes T1016 and T1017, effective from January 1, 2022, to December 31, 2299.

Highlights

  • •New rates for T1016 and T1017 introduced.
  • •Effective date: January 1, 2022, to December 31, 2299.
  • •Max fee for T1016 is 4.78.
  • •Max fee for T1017 is 7.83.

Reason

The effective date is historical, starting in 2022, and does not indicate immediate changes.

Watch items

T1016T10172022010122991231

VISN_max_fee_20261003.txt

low

The document contains Medicaid rate entries for various vision-related services with effective dates from 2008 to 2299, indicating it is archival or placeholder data.

Highlights

  • •Rates for vision services with codes like 65205, 65210, 65220, 65222, 65430, 65435.
  • •Effective dates range from 20080701 to 22991231.
  • •Rates include values such as 34.54, 47.59, 46.10, 47.18, 24.14, 59.10.
  • •Regions covered include codes like i~01;05;06;07;08;09;11;19;20;21;22;23;24;25;26;49;50;51;57;60;61;71;72.

Reason

The document appears archival with effective dates far in the past and future, indicating no immediate impact.

MEDSV_max_fee_20261003.txt

low

The document contains Medicaid rate entries for various medical services with effective dates from 2019 to 2299. Rates for services such as 10004, 10005, and 58100 are specified, but no immediate changes or new effective dates are indicated.

Highlights

  • •Rates for services 10004, 10005, 10006, 58100, 58110, and 58120 are listed.
  • •Effective dates range from 2019 to 2299.
  • •No new or immediate changes in rates are evident.

Reason

The document appears to be archival with no immediate changes or new effective dates.

MHCSP_max_fee_20261003.txt

low

The document outlines Medicaid rates for mental health community support services, including specific CPT codes and maximum fees. Rates for code H0039 vary based on modifiers, with effective dates extending far into the future.

Highlights

  • •CPT code H0034 has a max fee of 9.17.
  • •CPT code H0039 has varying rates based on modifiers (e.g., 3.75, 5.63, 15.00, 22.51, 28.14).
  • •Effective dates range from 20040101 to 22991231.

Reason

The document appears to be archival with effective dates far in the future, indicating no immediate urgency for review.

Watch items

H0034H0039max fee 9.17max fee 3.75max fee 28.14

MHHC_max_fee_20261003.txt

low

The document includes Medicaid rate information for mental health services with specific CPT codes and fee schedules. Rates for codes 90785, 90791, 90847, and 90849 are detailed, with effective dates ranging from 2004 to 2299.

Highlights

  • •CPT code 90785 has a max fee of 0.00.
  • •CPT code 90791 has fees of 90.04 and 112.53 for different modifiers.
  • •CPT code 90847 has a fee of 90.04.
  • •CPT code 90849 has fees of 90.04, 112.53, and 72.03 for different modifiers.

Reason

The document appears to be archival with effective dates far in the past and future, indicating no immediate changes.

OUTPA_max_fee_20261003.txt

low

The document lists outpatient hospital service codes with associated maximum fees and effective dates, ranging from 2008 to 2020, valid until 2299.

Highlights

  • •Outpatient hospital codes include 78267, 80047, 80048, 84478, and others.
  • •Maximum fees are specified for each code, e.g., 9.88 for 78267.
  • •Effective dates range from 2008 to 2020, with an end date of 2299.
  • •No changes to existing rates or policies are indicated.

Reason

The document appears archival with no immediate changes to rates or policies.

HCPCC_max_fee_20261003.txt

low

The document includes a Medicaid rate entry for code T1026 with a maximum fee of 39.23, effective from 20180901 to 22991231.

Highlights

  • •Code: T1026
  • •Maximum fee: 39.23
  • •Effective date: 20180901
  • •End date: 22991231

Reason

The effective date is historical, and there is no indication it supersedes current policy.

Watch items

T102620180901

bhic_max_fee_20261003.txt

low

The document lists Medicaid rates for specific codes with effective dates from 2014 to 2299, indicating long-term applicability. Rates for codes H0038, S0280, and S0281 are specified.

Highlights

  • •Code H0038: $5.75
  • •Code S0280: $473.64
  • •Code S0281: $13.14
  • •Effective dates: 20140401 to 22991231

Reason

The document appears archival with effective dates starting in 2014, suggesting no immediate changes.

Watch items

H0038S0280S02812014040122991231

MHPW_max_fee_20261003.txt

low

The document includes Medicaid rate information for several codes, such as 98961, 98962, and H0002, with effective dates ranging from 2008 to 2299. Rates are specified, but no immediate changes or new effective dates are evident.

Highlights

  • •Codes: 98961, 98962, H0002, H0004
  • •Rates: $14.00, $12.95, $35.35, $20.23
  • •Effective dates: 20080701 to 22991231
  • •Modifiers: c53, hf, he

Reason

The document appears to contain historical rate information with no immediate changes or new effective dates.

REHAB_max_fee_20261003.txt

low

The document provides updated Medicaid reimbursement rates for various therapy and rehab services, effective from January 1, 2022, to December 31, 2299. Rates for specific codes such as 29065, 29075, and 97140 are included.

Highlights

  • •Rates for therapy-rehabs codes 29065, 29075, 29085, 29086, 29345, and 29355 are listed.
  • •Code 97140 has a rate of 28.41 with various modifiers.
  • •Effective date for all listed rates is January 1, 2022, to December 31, 2299.

Reason

The document appears to be archival with effective dates far in the past, indicating no immediate urgency for review.

Watch items

29065290752908529086293452935597140

SMV_max_fee_20261003.txt

low

The document outlines Medicaid transport service rates with effective dates from 2022 to 2299, including specific codes and maximum fees.

Highlights

  • •CPT code A0090 with max fee 24.05
  • •CPT code A0120 with max fee 12.59
  • •CPT code A0130 with max fee 12.59
  • •CPT code S0209 with max fee 0.48
  • •CPT code S0215 with max fee 1.32

Reason

The rates are effective from 2022 to 2299, indicating no immediate changes requiring urgent review.

Watch items

A0090A0120A0130S0209S0215

MHCCS_max_fee_20261003.txt

low

The document contains Medicaid rate information for mental health services with specific CPT codes and modifiers, effective from 2014 to 2299. Rates for CPT code 99199 and H2017 are detailed with various modifiers.

Highlights

  • •CPT code 99199 with modifiers hn;hq, hn;u5, ho;hq, ho;u5, hp;hq, hp;u5.
  • •CPT code H2017 with modifiers hq;u9, hq;ua, hq;ub, hq;uc.
  • •Rates effective from 20140701 to 22991231.
  • •Rates range from 3.49 to 40.00.

Reason

The document appears historical with effective dates starting in 2014 and extending far into the future, suggesting no immediate changes.

MHADC_max_fee_20261003.txt

low

The document lacks any content or evidence to assess changes.

Highlights

  • •Document is empty with no content.
  • •No rate or policy changes identified.

Reason

No evidence of changes or updates is present.

ANSTH_max_fee_20261003.txt

low

The document contains anesthesia-related Medicaid rate entries with specific CPT codes and modifiers, but all effective dates are historical, starting from 2008 and ending in 2299.

Highlights

  • •CPT code 00100 with modifiers qk, qx, qy, qz.
  • •CPT code 00928 with modifiers qy, qz.
  • •CPT code 00930 with modifiers qk.

Reason

The effective dates are historical, starting in 2008, indicating archival data.