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68 <br /> Commissioner Approved <br /> Fee Changes for Last <br /> Department/Program Description Current Fee FY 2021-22* Revision <br /> 99000 Lab:Handling Fee $11.00 2009 <br /> 99070 Special Supplies $18.00 2009 <br /> 99080 Screening Form Completion $0.00 2018 <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 <br /> 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/G0436 Tobacco Use Cessation Counseling-(3-10 min) $13.00 2015 <br /> 99407/G0437 Tobacco Use Cessation Counseling-(10+min) $32.00 2015 <br /> 99408/G0396 JETOH&Substance Abuse Screening(15-30 min) $35.00 2018 <br /> 99409/G0397 JETOH&Substance Abuse Screening(30+min) $67.00 2018 <br /> 99441 iTelephone Evaluation 5-10 min(15) N/A $15.00 New <br />