Below are the fee schedules and rates listed by codes for particular provider or facility types.
Envision
- Envision fee schedules and rates – on the Envision web portal
- Envision fee schedules – downloadable
- Envision fee schedules – interactive, look up a procedure code and date of service
| Fee Schedules | File Type | File Type | Effective Date |
|---|---|---|---|
| Ambulance | Excel | July 1, 2021 | |
| Ambulatory Surgical Center Fee Schedule for DOS | Excel | July 1, 2021 | |
| Anesthesia Base Unit | Excel | July 1, 2021 | |
| Assisted Living (AL) Waiver | Excel | July 1, 2021 | |
| Autism Spectrum Disorder (ASD) Services | Excel | July 1, 2021 | |
| Clinician Administered Drugs and Implantable Drug System Devices | July 1, 2018 | ||
| Community Mental Health Services | Excel | July 1, 2021 | |
| Community Transition Services (CTS) | Excel | July 1, 2021 | |
| Dental Fees – Professional Services | Excel | July 1, 2021 | |
| Durable Medical Equipment (DME), Orthotic, Prosthetic | Excel | July 1, 2021 | |
| Elderly & Disabled (E&D) Waiver | Excel | July 1, 2021 | |
| Extended Services for the Perinatal High Risk Management and Infant Service System (PHRMISS) | Excel | July 1, 2021 | |
| Hearing | Excel | July 1, 2021 | |
| Increased Primary Care Provider | Excel | July 1, 2021 | |
| Independent Living (IL) Waiver | Excel | July 1, 2021 | |
| Intellectual and Developmental Disabilities (ID/DD) Waiver | July 1, 2018 | ||
| Intellectual/Developmental Disabilities 1915(i) Community Support Program | Jan. 1, 2019 | ||
| Medical Supply | Excel | July 1, 2021 | |
| Medication Assisted Treatment for Opioid Treatment Services | Excel | April 1, 2021 | |
| Out-of-State Hospital Transplant Services’ Case Rates | Excel | July 1, 2019 | |
| Outpatient Prospective Payment System (OPPS) Medicaid | Excel | July 1, 2021 | |
| Pathology Laboratory | Excel | July 1, 2021 | |
| Prescribed Pediatric Extended Care (PPEC) | Excel | July 1, 2021 | |
| Physician Administered Drug | Excel | July 1, 2021 | |
| Post-Eligibility Treatment of Income Deductions by Institutionalized Individuals | July 1, 2019 | ||
| Private Duty Nursing (PDN) Services | Excel | July 1, 2021 | |
| Psychiatry and Psychiatric Nurse Practitioners for Mental Health/Psychiatry Services | Excel | July 1, 2021 | |
| Radiology | Excel | July 1, 2021 | |
| Therapeutic and Evaluative Mental Health Services for Expanded EPSDT (T&E) | Excel | July 1, 2021 | |
| Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver | Excel | July 1, 2021 | |
| Vision | Excel | July 1, 2021 | |
| Vaccine | Excel | July 1, 2021 |
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.
