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7 <br /> ORANGE COUNTY HEALTH DEPARTMENT FEE SCHEDULE <br /> PERSONAL HEALTH SERVICES+NUTRITION <br /> Requested Fee <br /> CPT Code Change for FY Last <br /> Description Current Fee 2015-16 Revision <br /> 90853 Psychotherapy,Group $32.00 2009 <br /> 91781 IV infusion Each Additional Hour up to Eight $39.00 2009 <br /> 92551 jAudiometry $18.00 2008 <br /> 92587 OAE(Limited) $100.00 2012 <br /> 93000 Electrocardiogram,Complete $33.00 2009 <br /> 93005 Electrocardiogram,Tracing Only $22.00 2009 <br /> 94640 Airway Inhalation Treatment $22.00 2009 <br /> 94664 Aerosol/Vapor Inhalation Treatment $22.00 2009 <br /> 94760 Pulse Oxygen $8.00 2009 <br /> 96110 Developmental Test $23.00 2012 <br /> 96152 Health&Behavior Intervention $55.00 2012 <br /> 96372 Ther/Proph/Diag inj/SC/lM $60.00 2012 <br /> 97802 Medical Nutrition Therapy/luitial 15 min.Unit $30.00 2009 <br /> 97803 Medical Nutrition Therapy/Re-Assess 15 min.Unit $30.00 2009 <br /> 97804 Medical Nutrition Therapy-Group(2 or more) $15.00 2011 <br /> 99000 Lab:Handling Fee $11.00 2009 <br /> 99070 Special Supplies $18.00 2009 <br /> 99173 Vision $7.00 2009 <br /> 99175 Induction of Vomiting $67.00 2009 <br /> 99201 New Office/Outpt Tx Brief E&M $110.00 2009 <br /> 99202 New Office/Outpt Tx Expanded Prob Focused E&M $165.00 2009 <br /> 99203 New Office/Outpt Tx Detailed E&M $200.00 2009 <br /> 99204 New Office/Outpt Tx Moderate Complex E&M $335.00 2009 <br /> 99205 New Office/Outpt Tx High Complex E&M $405.00 2009 <br /> 99211 Estab Offic/Outpt Tx Brief E&M $60.00 2012 <br /> 99212 Estab Office/Outpt Tx Prob Focused E&M $100.00 2012 <br /> 99213 Estab Office/Outpt Tx Expanded Focused E&M $150.00 2012 <br /> 99214 Estab Office/Outpt Tx Detailed E&M $225.00 2012 <br /> 99215 Estab Office/Outpt Tx Comprehensive E&M $305.00 2012 <br /> 99381 Preventive/New Pt<1 yr. $255.00 2012 <br /> 99382 Preventive/New Pt 1-4 yrs. $270.00 2012 <br /> 99383 Preventive/New Pt 5-11 yrs. $275.00 2012 <br /> 99384 Preventive/New Pt 12-17 yrs. $235.00 2012 <br /> 99385 Preventive/New Pt 18-39 yrs. $235.00 2012 <br /> 99386 Preventive/New Pt 40-64 yrs. $267.00 2009 <br /> 99387 Preventive/New Pt 65+yrs. $242.00 2008 <br /> 99391 Preventive/Estab Pt<1 yr. $225.00 2012 <br /> 99392 Preventive/Estab Pt 1-4 yrs. $225.00 2012 <br /> 99393 Preventive/Estab Pt 5-11 yrs. $200.00 2012 <br /> 99394 Preventive/Estab Pt 12-17 yrs. $205.00 2012 <br /> 99395 Preventive/Estab Pt 18-39 yrs. $225.00 2012 <br /> 99396 Preventive/Estab Pt 40-64 yrs. $220.00 2012 <br /> 99397 Preventive/Estab Pt 65+yrs. $212.00 2004 <br /> 99406 Tobacco Use Cessation Counseling-Intermediate $10.66 $13.00 2012 <br /> 99407 Tobacco Use Cessation Counseling-Intensive $22.10 $32.00 2012 <br /> 99420 Health Check Autism Assessment $9.20 2015 <br /> Recoding Education Classes $30.00/hr 2010 <br /> Recoding Consultant Services(Health Educators) $20.00/hr 2010 <br /> Recoding Patient Education(non Physician) $35.00/unit 2012 <br /> Recoding Health Risk Appraisal $12.00 2004 <br /> 82465QW Cholesterol $11.00 2011 <br /> 82947QW Glucose(Random) $18.00 2006 <br /> 82950QW O'Sullivan 1 $28.00 2007 <br /> 82951QW OGTT(3 HR) $50.00 2006 <br /> 83036QW lHemoglobin A1C $21.00 1 2006 <br /> Page 5 of 6 <br />