Medicaid Provider Procedure Fee Increases
Physicians, Midwives, Nurse Practitioners, Optometrists
Procedure Fee Increases Effective October 1, 2000. These fee increases will be effective for dates of service on and after October 1, 2000 for services applicable to your provider type. This document is also available as an Adobe Portable Document Format (PDF) file.
| Code | Office Visit Fees | Fee as of 10/1/00 |
|---|---|---|
| 99201 | Office visit, E&M, new pt., minimal | $30.00 |
| 99202 | Office visit, E&M, new pt., minor | $30.00 |
| 99203 | Office visit, E&M, new pt., low complexity | $30.00 |
| 99204 | Office visit, E&M, new pt., moderate complexity | $30.00 |
| 99205 | Office visit, E&M, new pt., high complexity | $30.00 |
| 99211 | Office visit, E&M, established pt., minimal | $30.00 |
| 99212 | Office visit, E&M, established pt., minor | $30.00 |
| 99213 | Office visit, E&M, established pt., low complexity | $30.00 |
| 99214 | Office visit, E&M, established pt., moderate complexity | $30.00 |
| 99215 | Office visit, E&M, established pt., high complexity | $30.00 |
| 92002 | Ophth. Serv. Eye Exam + Eval., intermediate, new pt. | $30.00 |
| 92004 | Ophth. Serv. Eye Exam + Eval., comprehensive, new pt. | $30.00 |
| 92012 | Ophth. Serv. Eye Exam + Eval., intermediate, est. pt. | $30.00 |
| 92014 | Ophth. Serv. Eye Exam + Eval., comprehensive, est. pt. | $30.00 |
| 99381 | C/THP preventive-under 1 yr., new pt. | $30.00 |
| 99382 | C/THP preventive-early childhood-age 1-4 yrs., new pt. | $30.00 |
| 99383 | C/THP late childhood-age 5-11 yrs., new pt. | $30.00 |
| 99384 | C/THP adolescent-age 12-17 yrs., new pt. | $30.00 |
| 99385 | C/THP 18-20 yrs., new pt. | $30.00 |
| 99391 | C/THP preventive-under 1 yr., established pt. | $30.00 |
| 99392 | C/THP preventive-early childhood- age 1-4 yrs.established pt. | $30.00 |
| 99393 | C/THP late childhood-age 5-11 yrs., established pt. | $30.00 |
| 99394 | C/THP adolescent-age 12-17 yrs. established pt. | $30.00 |
| 99395 | C/THP 18-20 yrs. established pt. | $30.00 |
| Emergency Room Specialty Fees Specialty Code 250 Only |
||
| 99281 | Emer. Dept. Visit, E&M, self limited or minor | $17.00 |
| 99282 | Emer. Dept. Visit, E&M, low to moderate severity | $17.00 |
| 99283 | Emer. Dept. Visit, E&M, moderate severity | $17.00 |
| 99284 | Emer. Dept. Visit, E&M, high severity | $17.00 |
| 99285 | Emer. Dept. Visit, E&M, high severity, threat to life | $17.00 |
| Anesthesia Conversion Factor Increase | ||
| Anesthesia conversion factor increased to $10.00 |
Claims that have been paid for dates of service on or after October 1, 2000 with the previous fee(s) can be adjusted by following the claim adjustment instructions in the billing section of your MMIS Provider Manual.
Questions may be directed to the New York State Department of Health, Bureau of Policy Development and Agency Relations.