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Manager Recommended Fee Schedule ® FY 2022 ®23 51 <br /> Last <br /> Department/Program Description Current Fee Revision <br /> i <br /> 94150 Peak Flow $3 . 25 2018 <br /> 94640 Airway Inhalation Treatment $22 . 00 2009 <br /> 94664 Aerosol Inhalation Treatment - Teaching $22 . 00 2009 <br /> 94760 Pulse Oxygen $ 8 . 00 2009 <br /> 96110 Developmental Test $23 . 00 2012 <br /> 96125 ASQ - Developmental $ 78 . 38 2018 <br /> 96127 Social- emotional Screens $ 6 . 00 2017 <br /> 96152 Health & Behavior Intervention $55 . 00 2015 <br /> 96160 Adolescent Risk & Strength Screening $9 . 20 2017 <br /> 96161 Maternal Depression Screening $ 9 . 20 2017 <br /> 96372 Ther/Proph/Diag mJ /SC/IM $ 60 . 00 2012 <br /> 97802 Medical Nutrition Therapy/Initial 15 min. Unit $34 . 00 2015 <br /> 97803 Medical Nutrition Therapy/Re-Assess 15 min. Unit $34 . 00 2016 <br /> 97804 Medical Nutrition Therapy- Group (2 or more) $ 15 . 00 2011 <br /> 97804ud MDPP Fee $25 . 00 2017 <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 E &M $ 165 . 00 2009 <br /> 99203 New Office/Outpt Tx Detailed E &M $200000 2009 <br /> 99204 New Office/Outpt Tx Moderate Complex E &M $335000 2009 <br /> 99205 New Office/Outpt Tx High Complex E&M $405000 2009 <br /> 99211 Estab Offic/Outpt Tx Brief E&M $ 60 . 00 2012 <br /> 99212 Estab Office/Outpt Tx Prob Focused E &M $ 100000 2012 <br /> 99213 Estab Office/Outpt Tx Expanded Focused E&M $ 150900 2012 <br /> 99214 Estab Office/Outpt Tx Detailed E&M $225600 2012 <br /> 99215 Estab Office/Outpt Tx Comprehensive E &M $305 . 00 2012 <br /> 99381 Preventive/New Pt < 1 yr. $255000 2012 <br /> 99382 Preventive/New Pt 1 -4yrs . $270400 2012 <br /> 99383 Preventive/New Pt5 - 11yrs . $275 , 00 2012 <br /> 99384 Preventive/New Pt 12- 17 yrs . $235000 2012 <br /> 99385 Preventive/New Pt 18-39 yrs . $235000 2012 <br /> 99386 Preventive/New Pt 40-64 yrs . $267400 2009 <br /> 99387 Preventive/New Pt 65+ yrs . $242 . 00 2008 <br /> 99391 Preventive/stab Pt < 1 yr. $225400 2012 <br /> 99392 Preventive/Estab Pt 14 yrs . $225000 2012 <br /> 99393 Preventive/stab Pt 5 - 11 yrs . $200000 2012 <br /> 99394 Preventive/stab Pt 12- 17 yrs . $205000 2012 <br /> 99395 Preventive/Estab Pt 18-39 yrs . $225600 2012 <br /> 99396 Preventive/Estab Pt 40- 64 yrs . $220 . 00 2012 <br /> 99397 Preventive/stab Pt 65+ yrs . $212000 2004 <br /> 99401 Covid Counseling-Preventive Medicine Counseling, <br /> 15 min. $45 . 00 2022 <br /> 99406/G0436 Tobacco Use Cessation Counseling - (340 min) $ 13 . 00 2015 <br /> 99407/G0437 Tobacco Use Cessation Counseling - ( 10+ min) $32 . 00 2015 <br /> 99408/G0396 ETOH & Substance Abuse Screening ( 15 -30 min) 35 . 00 2018 <br /> 99409/G0397 ETOH & Substance Abuse Screening (30+ min) $ 67 . 00 2018 <br /> 99441 Telephone Evaluation 540 min $ 15 . 00 2021 <br /> 99442 Telephone Evaluation 11 -20 min $25 . 00 2021 <br /> 99443 Telephone Evaluation 21 -30 min $30 . 00 12021 <br /> 99499 DOT Physical $ 100 . 00 12019 <br />