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Commissioner Approved Fee Schedule- FY 2017-18 ATTACHMENT 4 41 <br /> Commissioner Approved <br /> Fee Change for Last <br /> De artment/Pro ram Description Current Fee FY 2017-18* Revision <br /> 96372 Ther h/Dia in/SC/IM $60.00 2012 <br /> 97802 Medical Nutrition Th /butial 15 min.Unit $30.00 2009 <br /> 97803 Medical Nutrition Therapy/Re-Assess 15 min Unit $34.00 2016 <br /> 97804 Medical Nutrition Th -G 2 or more $15.00 2011 <br /> 99000 Lab:Handling Fee $11.00 2009 <br /> 99070 S ial Soon' $18.00 2009 <br /> 99173 Vision $7.00 2009 <br /> 99175 Induction oNomiting $67.00 2009 <br /> 99201 N-0 tot Tx BdefF&M $110.00 2009 <br /> 99202 N-0 celOutpt Tx Expanded Prob Focused <br /> E&M $165.00 2009 <br /> 99203 New Office/Outpt Tx Detailed E&M $200.00 2009 <br /> 99204 New Offrce/Ou TL.Moderate Cmn lex E&M $335.00 2009 <br /> 99205 New Office/Ou t Tx Hi Com lex E&M $405.00 2009 <br /> 99211 Estab OtHc/O t Tx Bdef F&M $60.00 2012 <br /> 99212 Estab 0t-,Z t Tx Prob Focused E&M $100.00 2012 <br /> 99213 Estab Ot&ce/O t Tx Evanded Focused E&M $150.00 2012 <br /> 99214 Estab Office/Outpt Tx Detailed E&M $225.00 2012 <br /> 99215 Estab Officc/Outpt Tx Comprehensive E&M $305.00 2012 <br /> 99381 to,entive/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 PI 18-39 $235.00 2012 <br /> 99386 Preventive/New Pt 40-64 $267.00 2009 <br /> 99387 PrevendvetNew Pt 65+ $242.00 2008 <br /> 99391 Prevendve/EStab Pt<1 $225.00 2012 <br /> 99392 Prevenfive/Egab Pt 1-0 $225.00 2012 <br /> 99393 Pteven[ivelEstab Pt 5-11 $200.00 2012 <br /> 99394 Preventive/Estab Pt 12-17 yrs. $205.00 2012 <br /> 99395 P-cutive/Estab R 18-39 $225.00 2012 <br /> 99396 Preventive/Estab Pt 40 4 $220.00 2012 <br /> 99397 Preventive/Estab Pt 65+yrs. $212.00 2004 <br /> DSME(Diabetes Self Management Education) <br /> minimmn 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 lEducat-Classes $30.00/1. 2010 <br /> Recoding onsultant Services ealth Educators $20.00/1. 2010 <br /> Recodi Patient Education n <br /> $35.00/unit 2012 <br /> R.,xiding ealth Risk Appraisal $12.00 2004 <br /> 82465 W Cholesterol $11.00 2011 <br /> 82947 W Glucose om $18.00 2006 <br /> 82950 W O'Sullivan $28.00 2007 <br /> 82951 W OGTT 3 HR $50.00 2006 <br /> 83036 W Hemo obis AIC $21.00 2006 <br /> 85018QW Henioglob. $11.00 2009 <br /> 88175-90 Pa Thin State Lab $18.38 2012 <br /> D0145 Oral Evaluation<3 with counseling $55.00 2012 <br /> D1206 To ical Fluoride A 1 $47.00 2012 <br /> Recode Employee Varicella Titer(UNC Lab) $78.00 2009 <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 2017-18 Commissioner Approved Fee Schedule <br />