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Commissioner Approved Fee Schedule - FY 2016-17 ATTACHMENT 4 <br /> 48 <br /> Approved Fee Change for Last <br /> Department/Program Description Current Fee FY 2016-17 Revision <br /> Liletta N/A 10 $50.00 NEW <br /> Pap Smear with Interpretation N/A 11 $26.50 NEW <br /> HPV N/A 11 $25.00 NEW <br /> Pap Smear with Doctor Interpretation N/A 11 $80.00 NEW <br /> 92551 Audi ome $18.00 2008 <br /> 92587 OAE Limited $100.00 2012 <br /> 93000 Electrocaudiolzrann,Complete $33.00 2009 <br /> 93005 Electrocaudiogrann,Tracing Only $22.00 2009 <br /> 94640 Aftnva y Inhalation Treatment $22.00 2009 <br /> 94664 Aerosol/Vapor Inhalation Treatment $22.00 2009 <br /> 94760 Pulse Ox gen $8.00 2009 <br /> 96110 Develo mental Test $23.00 2012 <br /> 96152 Health&Behavior Intervention $55.00 2012 <br /> 96372 Ther/Pro h/Di in'/SC/IM $60.00 2012 <br /> 97802 Medical Nutrition Thera /Initial 15 min.Unit $30.00 2009 <br /> 97803 Medical Nutrition Thera /Re-Assess 15 min.Unit $30.00(12) 534.00 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/Out t Tx Brief E&M $110.00 2009 <br /> 99202 New Office/Outpt Tx Expanded Prob Focused <br /> E&M $165.00 2009 <br /> 99203 New Office/Out t Tx Detailed E&M $200.00 2009 <br /> 99204 New Office/Out t Tx Moderate Complex E&M $335.00 2009 <br /> 99205 New Office/Out t Tx High Complex E&M $405.00 2009 <br /> 99211 Estab Offic/Out t 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/Nm Pt<1 yr. $255.00 2012 <br /> 99382 Preventive/Nm Pt 1-4 yrs. $270.00 2012 <br /> 99383 Preventive/Nm Pt 5-11 yrs. $275.00 2012 <br /> 99384 Preventive/Nm Pt 12-17 yrs. $235.00 2012 <br /> 99385 Preventive/Nm Pt 18-39 s. $235.00 2012 <br /> 99386 Preventive/Nm Pt 40-64 yrs. $267.00 2009 <br /> 99387 Preventive/Nm Pt 65+yrs. $242.00 2008 <br /> 99391 Preventive/Estab Pt<1 yr. $225.00 2012 <br /> 99392 Preventive/Estab Pt 1-0 yrs. $225.00 2012 <br /> 99393 Preventive/Estab Pty-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 /> DSME(Diabetes Self Management Education) <br /> minimum fee $20.00 2015 <br /> 99406 Tobacco Use Cessation Counseling-Intermediate $13.00 2015 <br /> 99407 Tobacco Use Cessation Counseling-Intensive $32.00 2015 <br /> 99420 Health Check Autism Assessment $9.20 2015 <br /> Recoding Education Classes I$30.00/hr 2010 <br /> * Any fee changes wi I I be included in this column; <br /> a blank beside each fee means there is no fee change in FY 2016-17 Manager Recommended Fee Schedule <br />