Wisconsin

high

Max Fee Download

SUCCESS

Run Date and Time

Apr 15, 2026

1m 40s

Run Metrics

New48
Changed0
Unchanged0
Checked48

Fee Schedule Impacts

High12
Medium15
Low21

Run summary

This run for Wisconsin ForwardHealth Max Fee / max-fee-download identified 0 changed documents and 48 newly discovered documents. 12 item(s) are high priority. 4 newly discovered item(s) appear current or upcoming.

High Impact (12)

DME_max_fee_20260404.txt

high

The document includes updates to Medicaid rates for durable medical equipment, with specific changes effective January 1, 2024, for code K0855.

Highlights

  • New rate for K0855 effective 2024-01-01: $10,707.60
  • Additional rate for K0855 effective 2024-01-01: $53.54
  • Rates for codes 94762, 94772, and A4210 remain unchanged since 2008

Reason

The document includes new rates effective soon, impacting reimbursement.

Watch items

K085520240101

AMBUL_max_fee_20260404.txt

high

The document includes updates to ambulance transport rates with specific effective dates and maximum fees for various codes.

Highlights

  • New rate for code 90480: $44.95 effective 2025-10-01.
  • Rate for code 90611: $15.00 effective 2022-10-01, changing to $247.34 on 2026-02-01.
  • Rates for codes A0396 and A0398: $41.07 and $23.96 effective 2023-02-01.

Reason

The document contains specific rate changes with upcoming effective dates that impact reimbursement.

Watch items

9048090611A0396A03982025-10-01

DTAOD_max_fee_20260404.txt

high

The document outlines Medicaid rates for day treatment services, including specific CPT codes and maximum fees. Notably, a new rate for code 80305 is effective from July 1, 2023.

Highlights

  • New rate for code 80305 effective July 1, 2023.
  • Maximum fee for code 80305 is $12.60.
  • Rates for code H2012 remain unchanged since 2008.
  • Document includes multiple service location codes.

Reason

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

Watch items

80305H201220230701

PNCCC_max_fee_20260404.txt

high

The document outlines new Medicaid rates for child care coordination services, effective from February 1, 2023, to December 31, 2299. It includes specific CPT codes and maximum fees for services such as H1000, H1002, H1003, H1004, and T1016.

Highlights

  • New rates for child care coordination services.
  • Effective date: February 1, 2023.
  • CPT codes: H1000, H1002, H1003, H1004, T1016.
  • Maximum fees specified for each service.

Reason

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

Watch items

H1000H1002H1003H1004T1016

CHIRO_max_fee_20260404.txt

high

The document outlines new Medicaid reimbursement rates for chiropractic services, effective January 1, 2024. Several CPT codes have updated maximum fees, impacting reimbursement rates for these services.

Highlights

  • New rates effective January 1, 2024.
  • CPT codes 72040, 72050, 72052, 72070, 72081 updated.
  • 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

7204072050720527207072081

behav_max_fee_20260404.txt

high

The document outlines updated Medicaid rates for various behavioral treatment codes, effective from February 1, 2023, to December 31, 2299. Rates for codes 97151, 97152, and 97154 are specified, with different maximum fees based on modifiers.

Highlights

  • Behavioral treatment code 97151 has a max fee of $25.90.
  • Behavioral treatment code 97152 has a max fee of $22.93.
  • Behavioral treatment code 97154 has varying max fees: $12.71, $6.39, and $3.65 depending on modifiers.
  • Effective date for changes is February 1, 2023.

Reason

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

Watch items

97151971529715420230201

HCRS_max_fee_20260404.txt

high

The document outlines Medicaid rate updates for home care-respiratory care services under CPT code 99504, with new rates effective from January 1, 2026. Rates vary based on modifiers 'td' and 'te'.

Highlights

  • CPT code: 99504
  • New rates effective: January 1, 2026
  • Modifier 'td' rate: $75.00
  • Modifier 'te' rate: $61.05

Reason

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

Watch items

995042026010175.0061.05

MIDWF_max_fee_20260404.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.

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 contains new reimbursement rates effective soon, impacting billing and reimbursement.

Watch items

3641536416590255940099204

WWWP_max_fee_20260404.txt

high

The document outlines new Medicaid reimbursement rates for the Wisconsin Well Woman Program, effective from July 1, 2024, and January 1, 2025, with rates extending to December 31, 2299.

Highlights

  • New rates for codes 00400, 00940, 10004-10011, 87426, 87624-87626, 87635, 88141-88165.
  • Effective dates: July 1, 2024, and January 1, 2025.
  • Rates valid until December 31, 2299.

Reason

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

Watch items

0040000940100042024070120250101

MHCI_max_fee_20260404.txt

high

The document outlines Medicaid rate updates for mental health crisis intervention services, including specific CPT codes and maximum fees effective from 2022 and 2023.

Highlights

  • CPT code 99281 with various modifiers has rates ranging from $47.42 to $148.16.
  • CPT code H2011 has a rate of $13.97 with modifier U8 and $37.04 with modifier UA.
  • Effective dates for these rates are from 20220901 to 22991231 and 20230101 to 22991231.

Reason

The document contains specific rate changes and effective dates that are current and impact reimbursement.

Watch items

CPT 99281CPT H2011Effective date 20220901Effective date 20230101Modifier UA

MHIHP_max_fee_20260404.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.
  • 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 that impact billing and policy.

Watch items

CPT 99199CPT H0004CPT H0022Effective date: 20240801

MHNTS_max_fee_20260404.txt

high

The document includes updates to Medicaid rates for mental health and narcotic treatment services, with specific CPT codes and effective dates provided.

Highlights

  • CPT 81025: Effective 2024-01-01, rate $8.90
  • CPT 86580: Effective 2008-07-01, rate $9.29
  • CPT 99001: Effective 2022-01-01, rate $3.97
  • CPT H0020: Various rates, effective 2022-01-01 and 2026-01-01

Reason

The document contains specific rate changes and effective dates impacting reimbursement.

Watch items

810258658099001H00202024-01-01
Medium Impact (15)

MISC_max_fee_20260404.txt

medium

The document includes updates to Medicaid reimbursement rates for specific CPT codes, such as 0373T and 19300, with effective dates ranging from 2017 to 2021 and extending to 2299.

Highlights

  • CPT code 0373T has a max fee of 18.34 effective from 2021.
  • CPT code 19300 has multiple entries with a max fee of 389.42 effective from 2017.
  • CPT code 81415 has a max fee of 3824.00 effective from 2020.

Reason

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

Watch items

0373T1930081415

THERP_max_fee_20260404.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, and 97116.
  • Rates vary by code and setting.

Reason

The document provides updated rates and effective dates, but changes are not imminent.

Watch items

2906529075971162022010122991231

C4K_max_fee_20260404.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 with max fee of 16.70.
  • Effective date range: 20220101 to 22991231.

Reason

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

Watch items

T101616.702022010122991231

ASTSG_max_fee_20260404.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, indicating changes in maximum fees.

Highlights

  • CPT code 12018: max fee $57.90 and $51.60
  • CPT code 12047: max fee $54.80 and $49.32
  • CPT code 12057: max fee $107.74
  • CPT code 35276: max fee $296.48 and $266.83
  • CPT code 35281: max fee $210.24 and $189.21

Reason

The document specifies rate changes for several CPT codes, but the effective dates are not imminent, reducing urgency.

Watch items

1201812047120573527635281

MHCSP_max_fee_20260404.txt

medium

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 starting from 20040101 to 22991231.

Highlights

  • CPT code H0034 with max fee $9.17.
  • CPT code H0039 with various modifiers and fees.
  • Effective dates range from 20040101 to 22991231.

Reason

The document provides detailed rate information but lacks imminent changes or new effective dates.

Watch items

H0034H0039Modifiers: hm, hn, ho, hp, u1, u2

SBS_max_fee_20260404.txt

medium

The document outlines new Medicaid reimbursement rates for various school-based services, effective from August 11, 2025, to December 31, 2299. It includes specific CPT codes and maximum fees for services such as 90846, 90847, and 99202.

Highlights

  • New rates for school-based services effective August 11, 2025.
  • Includes CPT codes 90846, 90847, 99202, among others.
  • Maximum fees specified for each service.
  • Effective period extends to December 31, 2299.

Reason

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

Watch items

90846908479920220250811

MHAOD_max_fee_20260404.txt

medium

The document includes updates to Medicaid rates for mental health services, specifically for CPT codes 80305, 90785, and 90846, with effective dates ranging from 20220101 to 22991231.

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.
  • CPT code 90846 has a max fee of 91.46 and 121.95 effective from 20220101.

Reason

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

Watch items

8030590785908462023070120220101

HOSPC_max_fee_20260404.txt

medium

The document outlines new Medicaid reimbursement rates for hospice services, effective October 1, 2025, through December 31, 2299. It includes specific rate changes for codes G0155 and T2042.

Highlights

  • New rates for hospice services effective 2025-10-01.
  • CPT code G0155 rates range from $15.83 to $17.30.
  • CPT code T2042 rates range from $167.73 to $226.68.

Reason

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

Watch items

G0155T204220251001

HHPC_max_fee_20260404.txt

medium

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

Highlights

  • CPT code 92507 has a max fee of $98.19 and $90.96.
  • CPT code 97139 has a max fee of $95.11 and $88.11.
  • CPT code 97799 has a max fee of $92.64 and $85.82.
  • CPT code 99600 has a future rate of $117.86 effective 2026.
  • CPT code s9123 has a future rate of $67.55 effective 2026.

Reason

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

Watch items

CPT 99600CPT s9123Effective date 20260101

WCDH_max_fee_20260404.txt

medium

The document outlines new maximum fee rates for various hemophilia-related HCPCS codes, effective from 2025 to 2299. These changes include specific rate adjustments for codes such as J7187, J7188, J7190, J7193, J7194, J7195, J7197, and J7198.

Highlights

  • New max fee for J7187: $1.49 effective 2025-07-01
  • New max fee for J7188: $3.23 effective 2025-01-01, $3.24 from 2026-04-01
  • New max fee for J7190: $1.11 effective 2026-01-01, $1.39 from 2026-04-01
  • New max fee for J7193: $1.37 effective 2026-01-01
  • New max fee for J7194: $1.70 effective 2025-07-01

Reason

The changes are relevant but not immediately effective, with future dates starting in 2025.

Watch items

J7187J7188J7190J7193J7194

SPEC_max_fee_20260404.txt

medium

The document outlines new maximum fee rates for state-purchased eyeglasses, effective from September 1, 2025, to December 31, 2299. Rates for various codes such as v2020, v2100, and v2299 are specified.

Highlights

  • New rates effective from 2025-09-01 to 2299-12-31.
  • Includes codes v2020, v2100, v2101, v2102, v2219, v2220, v2221, v2299, v2300, v2301.
  • Rates range from $4.20 to $105.00.

Reason

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

Watch items

v2020v2100v229920250901

AMBSR_max_fee_20260404.txt

medium

The document contains Medicaid rate updates for ambulatory surgical centers, with effective dates ranging from 2018 to 2026. Notably, new rates for certain codes 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.

Reason

The document includes future rate changes effective in 2026, which are not immediately urgent but relevant for future planning.

Watch items

372543725537256372573725837259

AUDHA_max_fee_20260404.txt

medium

The document outlines 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 92653: Max fee $66.21
  • CPT V5014: Max fee $154.11

Reason

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

Watch items

CPT 69210CPT 92502CPT 92653CPT V5014

LAB_max_fee_20260404.txt

medium

The document includes updates to medical laboratory rates, with specific CPT codes and effective dates provided. Notably, a new rate for code 0464u is set to take effect on July 1, 2025.

Highlights

  • New rate for CPT code 0464u effective 2025-07-01.
  • CPT code 80047 has a rate of $11.51 effective since 2015.
  • CPT code 80048 has a rate of $8.46 effective since 2020.
  • CPT code 86255 has a new rate effective 2025-01-01.

Reason

The document contains future rate changes, but they are not imminent.

Watch items

0464u effective 2025-07-0180047 rate $11.5180048 rate $8.4686255 effective 2025-01-01

CSMGT_max_fee_20260404.txt

medium

The document outlines updated Medicaid rates for case management services, including specific codes and maximum fees effective from 2022 and 2023.

Highlights

  • New rates for code H0006 with modifiers U1-U5, effective 2022-05-01.
  • Rate for code T1017 set at $11.98, effective 2023-02-01.
  • Multiple codes have specified effective dates extending to 2299-12-31.

Reason

The document contains updated rates and effective dates, but they are not imminently urgent.

Watch items

H0006T10172022050120230201
Low Impact (21)

MHHC_max_fee_20260404.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.

Watch items

CPT 90785CPT 90791CPT 90847CPT 90849

WCDC_max_fee_20260404.txt

low

The document contains rate information for anesthesia and lab services related to adult cystic fibrosis, with effective dates ranging from 2006 to 2029. Rates are specified for various modifiers and codes, but no new effective dates are indicated.

Highlights

  • Rates for anesthesia services (e.g., CPT 00160, 00520) with modifiers qk, qx, qy, qz.
  • Rates for lab services (e.g., CPT 85049, 85610) with modifiers qw.
  • Effective dates from 20061001 to 22991231.
  • No new effective dates or changes indicated.

Reason

The document appears to be archival with no new effective dates or changes impacting current reimbursement.

HCCM_max_fee_20260404.txt

low

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 extends far into the future, indicating archival status.

Watch items

T1016T10172022010122991231

WCDK_max_fee_20260404.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 are listed.
  • Codes include 00532, 00840, 86920, 86921, 86922, 86927.
  • Rates are effective from 20061001 to 22991231.
  • Modifiers such as qk, qx, qy, qz are included.

Reason

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

MHADC_max_fee_20260404.txt

low

The document lacks any content or evidence to assess changes.

Highlights

  • No content available for review
  • No effective dates or rate changes provided

Reason

The document contains no information to assess urgency or impact.

DMS_max_fee_20260404.txt

low

The document provides updated Medicaid reimbursement rates for specific supply codes, effective from historical dates but extending to 22991231. Rates for codes A4206, A4207, A4208, A4483, A4550, and A4556 are specified.

Highlights

  • Code A4206: Rate $0.22
  • Code A4207: Rate $0.18
  • Code A4208: Rate $0.17
  • Code A4483: Rate $3.18
  • Code A4550: Rate $7.25
  • Code A4556: Rate $4.05

Reason

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

Watch items

A4206A4207A4208A4483A4550A4556

ANSTH_max_fee_20260404.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.
  • Effective dates range from 20080701 to 22991231.

Reason

The effective dates are historical and extend far into the future, indicating no immediate changes.

MHCCS_max_fee_20260404.txt

low

The document contains Medicaid rate entries for mental health services with CPT codes 99199 and H2017, effective from 20140701 to 22991231. Rates vary based on modifiers such as hn, hq, u5, and others.

Highlights

  • CPT code 99199 with various modifiers has rates ranging from 3.49 to 40.00.
  • CPT code H2017 with modifiers hq, ua, ub, uc has rates from 3.49 to 13.39.
  • Effective date for all entries is 20140701 to 22991231.

Reason

The document appears historical with effective dates starting in 2014, suggesting archival status.

Watch items

CPT 99199CPT H2017Effective date 20140701

DENTL_max_fee_20260404.txt

low

The document contains dental service codes with specified maximum fees and effective dates. The rates for codes 10120 and d1351 are set at $46.45 and $23.10, respectively, with effective dates starting from 2008 and 2022.

Highlights

  • Dental code 10120: max fee $46.45, effective 2008-07-01 to 2299-12-31.
  • Dental code d1351: max fee $23.10, effective 2022-01-01 to 2299-12-31.

Reason

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

Watch items

10120d13512008070120220101

VISN_max_fee_20260404.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 future-oriented without immediate impact.

Highlights

  • Rates for vision services listed with effective dates from 2008 to 2299.
  • Includes codes like 65205, 65210, 65220, 65222, 65430, 65435, 92342, 92352.
  • Rates range from 16.01 to 59.10.
  • No new effective dates or immediate changes noted.

Reason

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

MHPW_max_fee_20260404.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 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.

bhic_max_fee_20260404.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: Rate $5.75
  • Code S0280: Rate $473.64
  • Code S0281: Rate $13.14
  • Effective dates: 20140401 to 22991231

Reason

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

Watch items

H0038S0280S0281

DTCHD_max_fee_20260404.txt

low

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

Highlights

  • Service: Day treatment-child
  • Code: H2012
  • Max fee: 39.04
  • Effective: 20220101 to 22991231

Reason

The effective date is historical, starting in 2022, and extends far into the future, indicating no immediate urgency.

Watch items

H2012202201012299123139.04

CCO_max_fee_20260404.txt

low

The document outlines Medicaid rates for the code G9002 under 'community care org' with specific maximum fees for different patient types, effective from January 1, 2009, to December 31, 2299.

Highlights

  • Code: G9002
  • Patient Type 1 Max Fee: $83.28
  • Patient Type 2 Max Fee: $13.50
  • Patient Type 3 Max Fee: $20.45
  • Effective Date: 20090101 to 22991231

Reason

The effective date is historical, starting in 2009, and extends far into the future, indicating archival status.

Watch items

G90022009010122991231

MEDSV_max_fee_20260404.txt

low

The document contains Medicaid rate information for various medical services with effective dates from 2019 to 2299, indicating long-term applicability. Rates for services such as 10004, 10005, and 10006 are specified, but no immediate changes or new effective dates are evident.

Highlights

  • Rates for services 10004, 10005, 10006 are listed.
  • Effective dates range from 2019 to 2299.
  • No new or immediate changes detected.

Reason

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

RDLGY_max_fee_20260404.txt

low

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

Highlights

  • CPT code 70010 with various modifiers and fees.
  • CPT code 76776 with different fee structures.
  • Effective dates from 2008 to 2299.
  • Modifiers include 'cg1', 'pr1', 'te1', 'c44', 'pro', 'tec'.

Reason

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

HCMCR_max_fee_20260404.txt

low

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 med complx' services.
  • CPT code G0506 with a max fee of 1201.41.
  • CPT code T2023 with a max fee of 434.24.
  • Effective date: January 1, 2022.
  • End date: December 31, 2299.

Reason

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

Watch items

G0506T20231201.41434.2420220101

SMV_max_fee_20260404.txt

low

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

Highlights

  • CPT codes: A0090, A0120, A0130, S0209, S0215
  • Effective dates: 20220101 to 22991231
  • Rates include max fees and modifiers like 'tk' and 'tp'

Reason

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

Watch items

A0090A0120A0130S0209S0215

OUTPA_max_fee_20260404.txt

low

The document provides outpatient hospital rates for various CPT codes, effective from 2008 to 2023, with no immediate changes indicated.

Highlights

  • Rates for CPT codes 78267, 78268, 80047, 80048, 80051, 80053, 80055, 80061, 84460, 84466, 84478, 84479, 84480, 84481, 84482.
  • Effective dates range from 2008 to 2023.
  • No new or changed rates are evident in the excerpts.

Reason

The document appears to be archival with no new rate changes or policy updates indicated.

REHAB_max_fee_20260404.txt

low

The document provides updated Medicaid reimbursement rates for various therapy and rehab services, effective from January 1, 2022, to December 31, 2299. Specific CPT codes such as 29065, 29075, and 97140 are included with their respective maximum fees.

Highlights

  • CPT 29065: Max fee $77.13
  • CPT 29075: Max fee $53.73
  • CPT 29085: Max fee $46.34
  • CPT 29086: Max fee $24.70
  • CPT 29345: Max fee $109.07
  • CPT 97140: Max fee $28.41

Reason

The effective dates are far in the future, indicating no immediate urgency for review.

Watch items

CPT 29065CPT 29075CPT 29085CPT 29086CPT 29345

HCPCC_max_fee_20260404.txt

low

The document includes a Medicaid rate entry for code T1026 with a maximum fee of 39.23, effective from 2018 to 2299.

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

T1026