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Fee Schedules and Rates

Click here to download the Comprehensive Fee Schedule.

Click here to go to the Interactive Fee Schedule on the Provider Portal.

 

Below are the fee schedules and rates listed by codes for particular provider or facility types.

 

Administered Drug Services

Clinician Administered Drugs and Implantable Drug System Devices                                 July 2018
Physician Administered Drugs October 2024

 

 

Dental Professional Services

Dental Fees – Professional Services                                                                                      October 2024

 

 

Hearing and Vision Services

Audiological (Hearing)                                                                                                            October 2024
Vision April 2024

 

 

Home and Community Based Services (HCBS) Waivers

Assisted Living (AL) Waiver                                                                                                      July 2023
Community Transition Services (CTS) October 2024
Elderly & Disabled (E&D) Waiver October 2024
Independent Living (IL) Waiver July 2023
Intellectual and Developmental Disabilities (ID/DD) Waiver July 2023
Intellectual/Developmental Disabilities 1915(i) Community Support Program November 2023
Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver July 2023

 

 

Hospital Services

Out-of-State Hospital Transplant Services’ Case Rates                                                                July 2019
Outpatient Prospective Payment System (OPPS)                                    October 2024

 

 

Laboratory and Radiology Services

Pathology Laboratory                                                                                                                        October 2024
Radiology October 2024

 

 

Medical Equipment and Supplies

Durable Medical Equipment (DME), Orthotic, Prosthetic                                                                October 2024
Medical Supply October 2024

 

 

Medical and Surgical Services

Ambulatory Surgical Centers Fee Schedule for DOS                                                                    October 2024
Anesthesia Base Unit April 2023
Medical and Surgical Services October 2024
Prescribed Pediatric Extended Care (PPEC) April 2023
Private Duty Nursing (PDN) Services April 2024
Therapy Services October 2024
Vaccine October 2024

 

 

Mental Health Services

Autism Spectrum Disorder (ASD) Services                                                                                      November 2024
Medication Assisted Treatment for Opioid Treatment Services November 2024
Behavioral Health Services October 2024

 

 

Transport Services

Ambulance                                                                                                                                        January 2024

 

 

Other Rates

 

Clinic Reimbursement

 

Long-Term Care Reimbursement

Nursing Facilities (NF)

October 1, 2024 – December 31, 2024 NH Rates
July 1, 2024 – September 30, 2024 NH Rates
April 1, 2024 – June 30, 2024 NH Rates
January 1, 2024 – March 31, 2024 NH Rates
October 2023 – December 2023 NH Rates
July 1, 2023-September 30, 2023 NH Rates
April 2023 – June 2023 NH Rates
January 2023 – March 2023 NH Rates
October 1, 2022 – December 31, 2022 NH Rates
May 1, 2022 – September 30, 2022 NH Rates
Calendar Year 2021 – June 2024 NH Rates
Calendar Year 2020 NH Rates
2025 Cost Report – New Bed Value
2024 Cost Report – New Bed Value
2023 Cost Report – New Bed Value
2022 Cost Report – New Bed Value
2021 Cost Report – New Bed Value
2020 Cost Report – New Bed Value
2019 Cost Report – New Bed Value
2018 Cost Report – New Bed Value
2017 Cost Report – New Bed Value
2024 Cost Report – Owners & Officers Salaries
2024 Cost Report – Allowable Board of Directors for LTCF
2023 Cost Report – Owners & Officers Salaries
2023 Cost Report – Allowable Board of Directors for LTCF
2022 Cost Report – Owners & Officers Salaries
2022 Cost Report – Allowable Board of Directors for LTCF
2021 Cost Report – Owners & Officers Salaries
2021 Cost Report – Allowable Board of Directors for LTCF
2020 Cost Report – Owners & Officers Salaries
2020 Cost Report – Allowable Board of Directors for LTCF
2019 Cost Report – Owners & Officers Salaries
2019 Cost Report – Allowable Board of Directors for LTCF
2018 Cost Report – Owners & Officers Salaries
2018 Cost Report – Allowable Board of Directors for LTCF
2017 Cost Report – Owners & Officers Salaries
2017 Cost Report – Allowable Board of Directors for LTCF

Hospice Rates by County

FY 2025 – Effective: October 2024
FY 2024 – Effective: October 2023
FY 2023 – Effective: October 2022
FY 2022 – Effective: October 2021
FY 2021 – Effective: October 2020
FY 2020 – Effective: October 2019
FY 2019 – Effective: October 2018
FY 2018 – Effective: October 2017

 

Providers must use current CPT, HCPCS, CDT and ICD10 books for correct coding.

 

Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright © 2018 American Dental Association. All rights reserved. Applicable FARS/DFARS Apply.

CPT only copyright 2019 American Medical Association. All rights reserved.