Wisconsin
highMax Fee Download
Run Date and Time
Aug 15, 2026
44s
Run Metrics
Fee Schedule Impacts
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)
MHIHP_max_fee_20260801.txt
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.
- •Effective date: August 1, 2024.
- •CPT code 99199 with modifiers hm, hn, ho.
- •CPT code H0004 with modifiers ua, ub.
- •CPT code H0022 with modifiers hm.
Reason
The document specifies new reimbursement rates and effective dates for Medicaid services starting soon.
Watch items
SBS_max_fee_20260801.txt
The document outlines new Medicaid rates for school-based services, effective from August 11, 2025, to December 31, 2299. It includes specific CPT codes and maximum fees for various services.
Highlights
- •New rates for school-based services effective August 11, 2025.
- •Includes CPT codes 90846, 90847, 92507, 92508, 92521, 92522, 99202, 99203, 99204, 99205, 99212, 99213.
- •Maximum fees range from $9.37 to $163.57.
- •Effective date: August 11, 2025, to December 31, 2299.
Reason
The document contains new reimbursement rates effective soon, impacting billing and policy.
Watch items
CHIRO_max_fee_20260801.txt
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 for chiropractic services effective January 1, 2024.
- •CPT codes include 72040, 72050, 72052, 72070, 73070, 73080.
- •Rates range from $22.49 to $61.56.
- •Effective dates for some codes extend to December 31, 2299.
Reason
The document includes specific rate changes effective soon, impacting reimbursements.
Watch items
WWWP_max_fee_20260801.txt
The document outlines new and updated reimbursement rates for the Wisconsin Well Woman Program, effective from 2024 and 2025, with some rates extending to 2299.
Highlights
- •New rates for CPT codes 00400, 00940, 10004, 10005, 10006, 10007, 77067, 81025, 81515, 87426, 87624, 87625, 87626, 87635, 88141.
- •Effective dates range from 2024 to 2025, with some rates valid until 2299.
- •Significant rate changes include increases for codes 10004, 10005, 10006, and 10007 starting 2026.
Reason
The document includes specific rate changes and effective dates starting soon, impacting reimbursement.
Watch items
MHNTS_max_fee_20260801.txt
The document includes updates to Medicaid rates for mental health and narcotic treatment services, with specific CPT codes and effective dates provided.
Highlights
- •New rate for code 81025 effective 2024-01-01.
- •Rates for code 86580 effective since 2008-07-01.
- •Multiple rates for code 99001 effective since 2022-01-01.
- •Rates for code H0020 with various modifiers effective since 2022-01-01.
- •Future rate for code H0020 with modifier U1 effective 2026-01-01.
Reason
The document contains specific rate changes and effective dates impacting reimbursement, with some changes effective imminently.
Watch items
MIDWF_max_fee_20260801.txt
The document introduces new Medicaid reimbursement rates for licensed midwives, effective January 1, 2024. It includes specific CPT codes with associated maximum fees.
Highlights
- •New rates for licensed midwives effective 2024-01-01.
- •CPT codes 36415, 36416, 59025, 59400, and 99204 are included.
- •Maximum fees are specified for each code.
- •Rates are valid until December 31, 2299.
Reason
The document specifies new reimbursement rates effective soon, impacting billing and reimbursement.
Watch items
DME_max_fee_20260801.txt
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, new rates for K0855 are effective from January 1, 2024.
Highlights
- •Rates for codes 94762, 94772, A4210 effective until 22991231.
- •New rate for K0855 effective from 20240101.
- •K0854 rates effective from 20220201.
- •Specific max fees provided for each code.
Reason
The document contains specific rate changes with upcoming effective dates, impacting reimbursement.
Watch items
HCRS_max_fee_20260801.txt
The document outlines Medicaid rate updates for home care-respiratory care services, specifically for CPT code 99504. New rates are set to take effect on January 1, 2026, with different maximum fees based on modifiers.
Highlights
- •CPT code 99504 for home care-respiratory care.
- •New rates effective January 1, 2026.
- •Modifier 'td' rate: $75.00.
- •Modifier 'te' rate: $61.05.
Reason
The document includes new reimbursement rates effective soon, impacting billing for specific services.
Watch items
PNCCC_max_fee_20260801.txt
The document outlines Medicaid rate updates for child care coordination services, effective from February 1, 2023, to December 31, 2299. It includes specific rates for various codes such as H1000, H1002, H1003, H1004, and T1016.
Highlights
- •Rates for H1000, H1002, H1003, H1004, T1016 updated.
- •Effective date: February 1, 2023.
- •Rates valid until December 31, 2299.
- •Includes modifiers like 'u2', 'tt', 'ua', 'ub', 'uc'.
Reason
The document contains specific rate changes effective now, impacting reimbursement.
Watch items
AMBUL_max_fee_20260801.txt
The document includes updates to ambulance transport rates with specific CPT codes and effective dates, some extending into 2025 and 2026.
Highlights
- •CPT 90480: $44.95 effective 2025-10-01
- •CPT 90611: $247.34 effective 2026-02-01
- •CPT 90611 (modifier sl): $0.00 effective 2026-02-01
- •CPT A0396: $41.07 effective 2023-02-01
- •CPT A0398: $23.96 effective 2023-02-01
Reason
The document contains new rate changes with future effective dates impacting reimbursement.
Watch items
behav_max_fee_20260801.txt
The document outlines updated Medicaid rates for behavioral treatment services, including specific CPT codes and maximum fees effective from February 1, 2023, to December 31, 2299.
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 now or soon.
Watch items
Medium Impact (16)
C4K_max_fee_20260801.txt
The document introduces a new Medicaid rate entry for the "care4kids" program with a specific code and fee.
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 lacks immediate effective date urgency.
Watch items
AUDHA_max_fee_20260801.txt
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
MHAOD_max_fee_20260801.txt
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, but no immediate changes are indicated.
Highlights
- •CPT code 80305 has a max fee of 12.60 effective from 20230701.
- •CPT code 90785 has a max fee of 12.43 effective from 20220101.
- •Effective dates for the rates extend to 22991231.
Reason
The document contains current rate information but lacks evidence of immediate changes impacting reimbursement.
Watch items
THERP_max_fee_20260801.txt
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 included.
Highlights
- •Updated rates for therapy services (OT/PT/Speech).
- •Effective dates: 20220101 to 22991231.
- •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 dates are not imminent, reducing urgency.
Watch items
MISC_max_fee_20260801.txt
The document includes updates to Medicaid reimbursement rates for specific CPT codes, such as 0373T and 81415, with effective dates ranging from 2021 to 2299. These updates may impact reimbursement policies.
Highlights
- •CPT code 0373T has a max fee update effective from 20210101 to 22991231.
- •CPT code 19300 has multiple entries with different max fees and effective dates starting from 20170701.
- •CPT code 81415 has a max fee of 3824.00 effective from 20200101 to 22991231.
Reason
The document contains rate updates for specific CPT codes, but the effective dates are not imminent.
Watch items
CSMGT_max_fee_20260801.txt
The document outlines new Medicaid case management rates for various codes, effective from 2022 and 2023, with expiration dates set far in the future.
Highlights
- •New rates for code G9012 with unspecified fee.
- •Rates for code H0001 set at $408.70, effective 2022-01-01.
- •Rates for code H0006 range from $161.33 to $1385.36, effective 2022-05-01.
- •Rates for code T1017 set at $11.98, effective 2023-02-01.
Reason
The document contains new rate information but the effective dates are not imminent.
Watch items
SPEC_max_fee_20260801.txt
The document outlines new maximum fee 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 rates.
Highlights
- •New rates effective from 2025-09-01 to 2299-12-31.
- •Codes v2020, v2100, v2101, v2102, v2219, v2220, v2221, v2299, v2300, v2301 have specified rates.
- •Maximum fee for v2299 is 105.00.
- •Maximum fee for v2100 and v2101 is 10.49.
- •Maximum fee for v2020 is 5.79.
Reason
The changes are not effective immediately but are relevant for future planning.
Watch items
DMS_max_fee_20260801.txt
The document includes updates to Medicaid reimbursement rates for specific supply codes, with effective dates ranging from 20040101 to 22991231. Notable codes include A4206, A4207, A4208, A4481, A4483, and A4550, with specified maximum fees.
Highlights
- •CPT code A4206: max fee $0.22
- •CPT code A4207: max fee $0.18
- •CPT code A4208: max fee $0.17
- •CPT code A4481: max fee $0.34
- •CPT code A4483: max fee $3.18
- •CPT code A4550: max fee $7.25
Reason
The document contains specific rate updates, but the effective dates are not imminent, reducing urgency.
Watch items
HHPC_max_fee_20260801.txt
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 impacting current reimbursement.
Watch items
MEDSV_max_fee_20260801.txt
The document contains Medicaid rate updates for various medical services, with effective dates from 2019 to 2299. It includes specific rate changes for codes 10004, 10005, 10006, 57310, 57311, and 57320.
Highlights
- •Rate changes for codes 10004, 10005, 10006, 57310, 57311, 57320
- •Effective dates range from 2019 to 2299
- •Different max fee categories: c30 and pt1
Reason
The document includes specific rate changes but the effective dates are not imminent, reducing urgency.
Watch items
HOSPC_max_fee_20260801.txt
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. Rates for these codes have been specified with various max fees.
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.
- •Multiple max fee entries for each code.
Reason
The changes are relevant but not urgent as they are effective in 2025.
Watch items
MHCI_max_fee_20260801.txt
The document contains updates to Medicaid rates for mental health crisis intervention services, specifically for CPT codes 99281 and H2011, with various modifiers and maximum fees listed. The effective dates for these rates are from 2022 and 2023, extending to 2299.
Highlights
- •CPT code 99281 with modifiers hn, ho, hp, u7, ua has rates $88.90, $88.90, $110.23, $47.42, $148.16 respectively.
- •CPT code H2011 with modifier u8 has a rate of $13.97, and with ua, $37.04.
- •Effective dates for these rates are from 20220901 to 22991231 for 99281 and from 20230101 to 22991231 for H2011.
Reason
The document provides specific rate updates for mental health services, but the effective dates are not imminent.
Watch items
DTAOD_max_fee_20260801.txt
The document outlines Medicaid rate updates for day treatment services, including specific CPT codes and fee changes effective from 2023 and 2026.
Highlights
- •CPT code 80305 with a max fee of $12.60 effective 2023-07-01.
- •CPT code H2012 with a max fee of $18.30 effective 2026-01-01.
- •Modifier 'hf;u6' for H2012 with a max fee of $35.60 effective 2026-01-01.
Reason
The document includes future rate changes but they are not imminent, requiring moderate urgency for review.
Watch items
AMBSR_max_fee_20260801.txt
The document contains Medicaid rate updates for ambulatory surgical centers, with effective dates ranging from 2018 to 2026. Notably, new rates for codes 37254, 37255, 37256, 37257, 37258, and 37259 are set to become effective in 2026.
Highlights
- •Rates for codes 10005, 10007, 10009, 10011, 10021, 10030, 10035, 10036, 10040 effective from 2018.
- •New rates for codes 37254, 37255, 37256, 37257, 37258, 37259 effective from 2026.
- •Rates range from $106.18 to $1097.28.
- •Document includes max fee details for each code.
Reason
The document includes future rate changes effective in 2026, which are not urgent for immediate review.
Watch items
WCDH_max_fee_20260801.txt
The document outlines new maximum fee rates for various hemophilia-related HCPCS codes, effective from 2025 to 2299. Notable changes include rate adjustments for codes J7187, J7188, J7190, J7193, J7194, J7195, and J7197, with specific effective dates provided.
Highlights
- •New rates for HCPCS codes J7187, J7188, J7190, J7193, J7194, J7195, J7197.
- •Effective dates range from 2025 to 2299.
- •Rate changes include J7187 at $1.49 (2025-2026) and $1.54 (2026-2299).
- •J7188 set at $3.24 from 2026 onwards.
- •J7190 rates are $1.25 (2026-2299) and $1.39 (2026).
Reason
The changes are relevant but not immediately effective, with future dates starting in 2025.
Watch items
LAB_max_fee_20260801.txt
The document includes updates to Medicaid reimbursement rates for medical laboratory services, with specific CPT codes and effective dates provided.
Highlights
- •CPT code 0464u with a max fee of $473.54 effective from 2025-07-01.
- •CPT code 80047 with a max fee of $11.51 effective from 2015-01-01.
- •CPT code 80048 with a max fee of $8.46 effective from 2020-01-01.
- •CPT code 86235 with a max fee of $17.93 effective from 2020-01-01.
- •CPT code 86255 with a max fee of $12.05 effective from 2020-01-01.
Reason
The document contains specific rate updates, but most effective dates are not imminent.
Watch items
Low Impact (21)
SMV_max_fee_20260801.txt
The document contains Medicaid rate information for transport services with specific CPT codes and maximum fees listed. The effective dates for these rates are from January 1, 2022, to December 31, 2299.
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 or urgency.
Watch items
DENTL_max_fee_20260801.txt
The document contains dental service codes 10120 and d1351 with specified maximum fees and effective dates. The rates for these codes are $46.45 and $23.10, respectively, with effective dates starting from 2008 and 2022, extending to 2299.
Highlights
- •Dental code 10120: max fee $46.45, effective 2008-2299.
- •Dental code d1351: max fee $23.10, effective 2022-2299.
Reason
The document appears to be archival with effective dates far in the future, indicating no immediate urgency for review.
MHHC_max_fee_20260801.txt
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 depending on modifiers.
- •CPT code 90847 has a fee of 90.04.
- •CPT code 90849 has fees of 90.04, 112.53, and 72.03 depending on modifiers.
Reason
The document appears to be archival with effective dates starting in 2004 and extending far into the future, indicating no immediate changes.
HCPCC_max_fee_20260801.txt
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 the end date is far in the future, indicating archival status.
Watch items
DTCHD_max_fee_20260801.txt
The document introduces a new entry for 'day treatment-child' with code H2012, effective from January 1, 2022, to December 31, 2299. The maximum fee is set at 39.04.
Highlights
- •New entry for 'day treatment-child' with code H2012.
- •Effective date: January 1, 2022, to December 31, 2299.
- •Maximum fee: 39.04.
Reason
The effective date is historical, indicating archival relevance rather than immediate impact.
Watch items
REHAB_max_fee_20260801.txt
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 codes 29065, 29075, 29085, 29086, 29345, 29355.
- •Code 97140 has a rate of 28.41.
- •Effective date range: 20220101 to 22991231.
Reason
The document appears to be archival with effective dates far in the future, indicating no immediate urgency for review.
Watch items
MHADC_max_fee_20260801.txt
The document lacks any content or evidence to assess changes.
Highlights
- •Document is empty with no content.
- •No regions or tokens emitted.
Reason
No evidence of changes or updates is present.
OUTPA_max_fee_20260801.txt
The document lists outpatient hospital service codes with associated maximum fees and effective dates, ranging from 2008 to 2020, with an end date of 2299. No immediate changes or new effective dates are indicated.
Highlights
- •Outpatient hospital codes listed with fees.
- •Effective dates range from 2008 to 2020.
- •End date for all entries is 2299.
- •No new or immediate changes noted.
Reason
The document appears to be archival with no new or urgent changes.
MHCCS_max_fee_20260801.txt
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.
- •Modifiers impact the maximum fee schedule.
Reason
The document appears historical with effective dates starting in 2014 and extending far into the future, suggesting no immediate changes.
WCDC_max_fee_20260801.txt
The document provides rate information for anesthesia and lab services related to adult cystic fibrosis, with effective dates ranging from 2006 to 2029. No new effective dates or changes are indicated.
Highlights
- •Rates for anesthesia services (CPT 00160, 00520) provided.
- •Rates for lab services (CPT 85049, 85610) provided.
- •Effective dates range from 20061001 to 22991231.
Reason
The document appears to be archival with no new changes or effective dates indicated.
RDLGY_max_fee_20260801.txt
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.
- •Effective dates range from 2008 to 2299.
Reason
The document appears to be archival with effective dates far in the past and extending into the future, indicating no immediate changes.
ASTSG_max_fee_20260801.txt
The document contains Medicaid rate information for various medical assistant services, with specific CPT codes and maximum fees listed. The effective dates for these rates range from 2008 to 2299, indicating they are not newly updated.
Highlights
- •CPT code 12018 has a max fee of $57.90 and $51.60.
- •CPT code 12047 has a max fee of $54.80 and $49.32.
- •CPT code 12057 has a max fee of $107.74.
- •CPT code 35276 has a max fee of $296.48 and $266.83.
- •CPT code 35281 has a max fee of $210.24 and $189.21.
Reason
The document appears to be archival with effective dates starting in 2008, indicating no urgent changes.
MHPW_max_fee_20260801.txt
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 indicated.
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 be archival with no new or imminent changes impacting reimbursement.
bhic_max_fee_20260801.txt
The document lists Medicaid rates for specific codes with effective dates from 2014 to 2299, indicating long-term applicability.
Highlights
- •Codes: H0038, S0280, S0281
- •Rates: $5.75, $473.64, $13.14
- •Effective: 20140401 to 22991231
- •Max fee schedule applied
Reason
The effective dates are far in the past and extend far into the future, suggesting archival status.
Watch items
CCO_max_fee_20260801.txt
The document provides rate information for the code G9002 under 'community care org' with different maximum fees for various patient types, effective from January 1, 2009, to December 31, 2299.
Highlights
- •Code G9002 listed under 'community care org'.
- •Different max fees for patient types: pt1, pt2, pt3.
- •Effective date range: 20090101 to 22991231.
Reason
The effective date is historical, starting in 2009, and extends far into the future, indicating archival status.
WCDK_max_fee_20260801.txt
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 are listed.
- •Codes include 00532, 00840, 86920, 86921, 86922, 86927.
- •Rates are effective from 2006 to 2299.
- •Modifiers such as qk, qx, qy, qz are included.
Reason
The effective dates are historical and extend far into the future, indicating no immediate urgency.
ANSTH_max_fee_20260801.txt
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, suggesting no immediate changes.
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, indicating no immediate impact on current reimbursement policies.
VISN_max_fee_20260801.txt
The document contains Medicaid rate entries for various vision-related services with effective dates from 2008 to 2299, indicating it is archival or future-oriented without immediate impact.
Highlights
- •Rates for vision services like 65205, 65210, 65220, 65222, 65430, 65435.
- •Effective dates range from 20080701 to 22991231.
- •Rates include 34.54, 47.59, 46.10, 47.18, 24.14, 59.10.
- •No new or immediate changes indicated.
Reason
The document appears archival with effective dates far in the future, indicating no immediate changes.
HCCM_max_fee_20260801.txt
The document introduces new Medicaid rates for health check case management services with codes T1016 and T1017, effective from January 1, 2022, to December 31, 2299.
Highlights
- •New rates for T1016: $4.78
- •New rates for T1017: $7.83
- •Effective date: January 1, 2022
- •End date: December 31, 2299
Reason
The effective date is historical, starting in 2022, and does not indicate immediate changes.
Watch items
HCMCR_max_fee_20260801.txt
The document introduces new Medicaid rates for high-cost medical complexity services, effective from January 1, 2022, to December 31, 2299.
Highlights
- •New rates for high-cost medical complexity services.
- •CPT codes G0506 and T2023 included.
- •Effective date: January 1, 2022.
- •End date: December 31, 2299.
- •Rates: $1201.41 and $434.24 respectively.
Reason
The effective date is historical, starting in 2022, with no indication of superseding current policy.
Watch items
MHCSP_max_fee_20260801.txt
The document outlines Medicaid rates for mental health community support services, including specific CPT codes and maximum fees. The rates are effective from 20040101 to 22991231, indicating they are not newly updated but rather ongoing.
Highlights
- •CPT code H0034 with a max fee of 9.17.
- •CPT code H0039 with various modifiers and fees ranging from 3.75 to 28.14.
- •Effective date range from 20040101 to 22991231.
Reason
The document appears to be archival with no recent changes impacting reimbursement.
Watch items