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Commissioner Approved Fee Schedule - FY 2018-19 <br />* Any fee changes will be included in this column; <br />a blank beside each fee means there is no fee change in FY 2018-19 Commissioner Approved Fee Schedule <br />Department/Program Description Current Fee <br />Commissioner Approved <br />Fee Change for <br />FY 2018-19* <br />Last <br />Revision <br />90853 Psychotherapy, Group $32.00 2009 <br />91781 IV infusion Each Additional Hour up to Eight $39.00 2009 <br />86382 Rabies Titer $100.00 2016 <br />99080 Record TB Screening Form Completion $25.00 2016 <br />TBD Minimum Lab Fee $20.00 2016 <br />J7297 Liletta $50.00 2016 <br />88175 Pap Smear with Interpretation $26.50 2016 <br />87624 HPV $25.00 2016 <br />88141 Pap Smear with Doctor Interpretation $80.00 2016 <br />92551 Audiometry $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 />94150 Peak Flow (10)$0.00 $3.25 NEW <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 />96125 ASQ Developmental (10)$0.00 $78.38 NEW <br />96127 Social-Emotional Screens $6.00 2017 <br />96152 Health & Behavior Intervention $55.00 2012 <br />96160 Adolescent Risk & Strength Screening $9.20 2017 <br />96161 Amaternal Depression Screening $9.20 2017 <br />62