2013-504 Health - UNC Faculty Physicians for Services in reference to NC Breast & Cervical Cancer Program $6,400

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North Carolina Breast and Cervical Cancer Control Program REF:North Carolina Breast and Cervical Cancer Control Program 2013-14 Fee Schedule Physician Visits Office Visits(2) CPT 12-13 Code Fee New patient,brief 99201 $ 41.56 New patient,limited 99202 $ 70.83 New patient,intermediate 99203 $ 102.72 Established patient,brief 99211 $ 19.29 Established patient,limited 99212 $ 41.56 Established patient,intermediate 99213 $ 69.35 00400 Anesthesia Not to exceed 3 Base Units plus Time Units(length of time spent providing anesthesia service in 15 minute increments)times Conversion Rate($21.09)or$250,whichever is lower. Global and Split Fees Both global and split fees apply to the breast procedures listed on page 1 of this fee schedule. The method and direction of payment will determine their usage for your facility. The following are the codes and definitions that apply: G=Global;the all-inclusive fee for performing and interpreting the service. TC=Technical Component;the fee for performing the service. 26=Professional Component;the fee for interpreting the service. Notes: (1) NC BCCCP covers only the physician's fee. Any facility charges associated with these CPT codes are not covered. (2) All consultations should be billed through the standard"new patient"office visit CPT codes:99201-99205. Consultations billed as 99204 or 99205 must meet the criteria for these codes,and must be pre-authorized. Codes 99204 and 99205 are not appropriate for screening visits. (3) HPV DNA testing is a reimbursable procedure if used for screening in conjunction with Pap testing or for follow-up of an abnormal Pap result or surveillance per ASCCP guidelines. It is not reimbursable as a primary screening test for women of all ages or as an adjunctive screening test to the Pap for women under 30 years of age. Providers should specify the high-risk HPV DNA panel only. Reimbursement of screening for low-risk HPV types is not permitted. The CDC will allow for reimbursement of Cervista HPV HR at the same rate as the Digene Hybrid-Capture 2 HPV DNA Assay. CDC funds cannot be used for reimubrsement of genotyping(e.g.,Cervista HPV 16/18). (4) Up to three cervical biopsies,including ECC(endocervical currettage),per colposcopy will be covered by the BCCCP when the appropriate algorithm is followed. Each specimen container is counted as one biopsy. Under no circumstances are endometrial or vaginal biopsies covered by the BCCCP. Revised: 3/22/12