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DATE: 05/02/2006 PROGRAM: MEDICAID Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published. TEXAS MEDICAID FEE SCHEDULE - PODIATRIST 1 of 35 Dear Podiatrist Provider: Texas Medicaid Fee Schedule Information Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) compiled the Texas Medicaid Fee Schedule to assist providers in determining payment amounts for specific services. Procedures listed in this fee schedule are payable based on the policies in effect for specific dates of service. The fee schedule contains a list of procedures and corresponding reimbursement. The reimbursement methodology for podiatrists can be found in Title 1 Texas Administrative Code (TAC), §355.8081. The following paragraphs are an overview of the current Texas Medicaid reimbursement methodologies used in this report. 1 TAC §355.8085 covers the reimbursement methodology for providers, which includes resource-based fees (RBFs) and access-based fees (ABFs). RBFs are based on relative value units (RVUs) times the current Texas statewide conversion factor for these services of $27.276. ABFs are developed to account for deficiencies in RBFs relating to adequate accessing of health care services for Medicaid clients. In addition to RBFs and ABFs for services provided by physicians and certain other practitioners, this fee schedule uses the reimbursement for clinical laboratory services located in 1 TAC §355.8610. The fee schedule field descriptions below are a guide for using the fee schedule. TMHP hopes this information is helpful in determining payment amounts for services provided. Thanks to providers for participating in the Texas Medicaid Program. Field Descriptions TOS: Type of service. One-digit TOS and corresponding description. Proc code: Procedure code. Modifier: Modifier required for specific procedure codes. TMRM payable: Texas Medicaid Reimbursement Methodology. The payable amount for the TOS and procedure code for providers, specifically RBFs. The payable amount is calculated by multiplying the total RVUs by the conversion factor ($27.276). Total RVUs: The current relative value units in TMHP files for the procedure code. Conv Factor: Conversion factor. The conversion factor amounts for determining either the TMRM payable or the anesthesia payable amount. Access-Based or Max Fee: The access-based fee amount or maximum fee. Note code: Note code indicator. It is important that each note code be reviewed to identify specific payment explanation or limitation. Note code description: 1 In an outpatient setting, this procedure is subject to a 60 percent payable if the diagnosis is nonemergency. 2 Clinical laboratory fee schedule procedure. 4 There must be medical documentation supporting the need for an inpatient setting. 5 This procedure is manually reviewed to determine pricing. 11 Fee schedule national crosswalk procedure code. TOS description: 1 Medical Services 2 Surgery 3 Consultation 4 Radiology 5 Laboratory. 8 Assistant Surgery 9 DME – Other I Professional Component T Technical Component Note: Medicaid payments for services by professional and outpatient facilities under fee-for-service and primary care case management (PCCM) programs covered by this fee schedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and durable medical equipment (DME) and supplies. For more information, refer to “Professional Providers and Outpatient Facilities Reimbursement Reduction” on page 2-8 of the 2006 Texas Medicaid Provider Procedures Manual, which is available for downloading from the TMHP website at http://www.tmhp.com. Texas Medicaid & Healthcare Partnership, 12365-A Riata Trace Parkway, Austin, TX 78727

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Page 1: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

1 of 35

Dear Podiatrist Provider:

Texas Medicaid Fee Schedule InformationPodiatrist

May 2006

The Texas Medicaid & Healthcare Partnership (TMHP) compiled the Texas Medicaid Fee Schedule to assist providers in determining payment amounts for specific services. Procedures listed in this fee schedule are payable based on the policies in effect for specific dates of service. The fee schedule contains a list of procedures and corresponding reimbursement. The reimbursement methodology for podiatrists can be found in Title 1 Texas Administrative Code (TAC), §355.8081. The following paragraphs are an overview of the current Texas Medicaid reimbursement methodologies used in this report.

1 TAC §355.8085 covers the reimbursement methodology for providers, which includes resource-based fees (RBFs) and access-based fees (ABFs). RBFs are based on relative value units (RVUs) times the current Texas statewide conversion factor for these services of $27.276. ABFsare developed to account for deficiencies in RBFs relating to adequate accessing of health care services for Medicaid clients.

In addition to RBFs and ABFs for services provided by physicians and certain other practitioners, this fee schedule uses the reimbursement for clinical laboratory services located in 1 TAC §355.8610.

The fee schedule field descriptions below are a guide for using the fee schedule. TMHP hopes this information is helpful in determining paymentamounts for services provided. Thanks to providers for participating in the Texas Medicaid Program.

Field DescriptionsTOS: Type of service. One-digit TOS and corresponding description.

Proc code: Procedure code.Modifier: Modifier required for specific procedure codes.

TMRM payable: Texas Medicaid Reimbursement Methodology. The payable amount for the TOS and procedure code for providers, specifically RBFs. The payable amount is calculated by multiplying the total RVUs by the conversion factor ($27.276).

Total RVUs: The current relative value units in TMHP files for the procedure code.Conv Factor: Conversion factor. The conversion factor amounts for determining either the TMRM

payable or the anesthesia payable amount.Access-Based or Max Fee: The access-based fee amount or maximum fee.

Note code: Note code indicator. It is important that each note code be reviewed to identify specific payment explanation or limitation.

Note code description: 1 In an outpatient setting, this procedure is subject to a 60 percent payable if the diagnosis is nonemergency. 2 Clinical laboratory fee schedule procedure. 4 There must be medical documentation supporting the need for an inpatient setting. 5 This procedure is manually reviewed to determine pricing. 11 Fee schedule national crosswalk procedure code.

TOS description: 1 Medical Services 2 Surgery 3 Consultation 4 Radiology 5 Laboratory. 8 Assistant Surgery 9 DME – Other I Professional Component T Technical Component

Note: Medicaid payments for services by professional and outpatient facilities under fee-for-service and primary care case management (PCCM) programs covered by this fee schedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and durable medical equipment (DME) and supplies. For more information, refer to “Professional Providers and Outpatient Facilities Reimbursement Reduction” on page 2-8 of the 2006 Texas Medicaid Provider Procedures Manual, which is available for downloading from the TMHP website at http://www.tmhp.com.

Texas Medicaid & Healthcare Partnership, 12365-A Riata Trace Parkway, Austin, TX 78727

Page 2: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

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TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

2 10040 $48.28 1.77 27.276 $0.002 10060 $45.55 1.67 27.276 $0.002 10061 $91.37 3.35 27.276 $0.002 10120 $49.10 1.80 27.276 $0.002 10121 $108.01 3.96 27.276 $0.002 10140 $54.55 2.00 27.276 $0.002 10160 $45.01 1.65 27.276 $0.002 10180 $98.19 3.60 27.276 $0.002 11000 $38.73 1.42 27.276 $0.002 11001 $21.00 0.77 27.276 $0.002 11010 $238.94 8.76 27.276 $0.002 11011 $284.76 10.44 27.276 $0.002 11012 $395.77 14.51 27.276 $0.002 11040 $30.00 1.10 27.276 $0.002 11041 $44.19 1.62 27.276 $0.002 11042 $55.64 2.04 27.276 $0.002 11043 $119.20 4.37 27.276 $0.002 11044 $166.38 6.10 27.276 $0.002 11055 $15.00 0.55 27.276 $0.002 11056 $21.00 0.77 27.276 $0.002 11057 $22.09 0.81 27.276 $0.002 11100 $33.82 1.24 27.276 $0.002 11101 $17.73 0.65 27.276 $0.002 11200 $33.28 1.22 27.276 $0.002 11201 $12.55 0.46 27.276 $0.002 11300 $30.82 1.13 27.276 $0.002 11301 $44.19 1.62 27.276 $0.002 11302 $56.46 2.07 27.276 $0.002 11303 $77.46 2.84 27.276 $0.002 11305 $34.91 1.28 27.276 $0.002 11306 $49.37 1.81 27.276 $0.002 11307 $60.83 2.23 27.276 $0.002 11308 $83.46 3.06 27.276 $0.002 11420 $45.55 1.67 27.276 $0.002 11421 $64.92 2.38 27.276 $0.002 11422 $78.83 2.89 27.276 $0.002 11423 $102.56 3.76 27.276 $0.002 11424 $118.38 4.34 27.276 $0.002 11426 $167.75 6.15 27.276 $0.002 11620 $78.83 2.89 27.276 $0.002 11621 $109.92 4.03 27.276 $0.002 11622 $134.47 4.93 27.276 $0.002 11623 $159.29 5.84 27.276 $0.002 11624 $198.57 7.28 27.276 $0.002 11626 $234.03 8.58 27.276 $0.002 11719 $10.09 0.37 27.276 $0.002 11720 $18.27 0.67 27.276 $0.002 11721 $30.82 1.13 27.276 $0.002 11730 $46.10 1.69 27.276 $0.002 11732 $18.27 0.67 27.276 $0.002 11740 $22.64 0.83 27.276 $0.002 11750 $113.47 4.16 27.276 $0.002 11752 $159.29 5.84 27.276 $0.002 11755 $66.55 2.44 27.276 $0.002 11760 $73.37 2.69 27.276 $0.002 11762 $162.29 5.95 27.276 $0.002 11765 $34.91 1.28 27.276 $0.002 12001 $65.46 2.40 27.276 $0.002 12002 $76.37 2.80 27.276 $0.002 12004 $98.19 3.60 27.276 $0.002 12005 $126.83 4.65 27.276 $0.002 12006 $160.66 5.89 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 3: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

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TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

2 12007 $174.02 6.38 27.276 $0.002 12020 $113.47 4.16 27.276 $0.002 12041 $93.01 3.41 27.276 $0.002 12042 $114.29 4.19 27.276 $0.002 12044 $139.93 5.13 27.276 $0.002 12045 $171.02 6.27 27.276 $0.002 12046 $212.21 7.78 27.276 $0.002 12047 $263.76 9.67 27.276 $0.008 12047 80 $42.28 1.55 27.276 $0.002 13131 $171.02 6.27 27.276 $0.002 13132 $264.85 9.71 27.276 $0.002 13160 $386.77 14.18 27.276 $0.002 14040 $420.05 15.40 27.276 $0.002 14041 $564.07 20.68 27.276 $0.002 15574 $447.05 16.39 27.276 $0.002 15620 $252.30 9.25 27.276 $0.002 15850 $0.00 0.00 0.000 $50.752 15851 $34.10 1.25 27.276 $0.002 15852 $39.28 1.44 27.276 $0.002 16020 $33.28 1.22 27.276 $0.002 17000 $31.37 1.15 27.276 $0.002 17003 $7.91 0.29 27.276 $0.002 17004 $142.93 5.24 27.276 $0.002 17106 $0.00 0.00 0.000 $114.842 17110 $28.37 1.04 27.276 $0.002 17250 $25.37 0.93 27.276 $0.002 17270 $48.82 1.79 27.276 $0.002 17271 $73.10 2.68 27.276 $0.002 17272 $87.28 3.20 27.276 $0.002 17273 $102.83 3.77 27.276 $0.002 17274 $128.47 4.71 27.276 $0.002 17276 $159.84 5.86 27.276 $0.002 17304 $283.40 10.39 27.276 $0.002 17305 $122.20 4.48 27.276 $0.002 17306 $95.47 3.50 27.276 $0.002 17307 $97.65 3.58 27.276 $0.002 17310 $14.18 0.52 27.276 $0.002 17340 $29.46 1.08 27.276 $0.002 20000 $79.37 2.91 27.276 $0.002 20005 $147.02 5.39 27.276 $0.002 20200 $79.10 2.90 27.276 $0.002 20205 $131.20 4.81 27.276 $0.002 20206 $59.73 2.19 27.276 $0.002 20520 $74.19 2.72 27.276 $0.002 20525 $166.11 6.09 27.276 $0.002 20526 $46.37 1.70 27.276 $0.002 20550 $45.28 1.66 27.276 $0.002 20551 $46.37 1.70 27.276 $0.002 20552 $46.37 1.70 27.276 $0.002 20553 $46.37 1.70 27.276 $0.002 20600 $34.10 1.25 27.276 $0.002 20605 $34.10 1.25 27.276 $0.002 20610 $37.10 1.36 27.276 $0.002 20612 $41.73 1.53 27.276 $0.002 20615 $79.92 2.93 27.276 $0.002 20650 $94.10 3.45 27.276 $0.002 20670 $0.00 0.00 0.000 $106.582 20680 $0.00 0.00 0.000 $163.428 20680 80 $0.00 0.00 0.000 $26.152 26770 $106.92 3.92 27.276 $0.002 26775 $138.02 5.06 27.276 $0.002 26776 $201.57 7.39 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 4: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

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TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

2 27605 $118.65 4.35 27.276 $0.002 27606 $181.66 6.66 27.276 $0.002 27610 $454.96 16.68 27.276 $0.008 27610 80 $72.83 2.67 27.276 $0.002 27612 $468.33 17.17 27.276 $0.002 27620 $364.68 13.37 27.276 $0.008 27620 80 $58.37 2.14 27.276 $0.002 27625 $513.88 18.84 27.276 $0.008 27625 80 $82.10 3.01 27.276 $0.002 27626 $609.07 22.33 27.276 $0.002 27647 $646.71 23.71 27.276 $0.008 27647 80 $103.38 3.79 27.276 $0.002 27648 $44.19 1.62 27.276 $0.002 27650 $506.24 18.56 27.276 $0.002 27652 $567.89 20.82 27.276 $0.002 27685 $296.49 10.87 27.276 $0.002 27690 $451.96 16.57 27.276 $0.008 27690 80 $72.28 2.65 27.276 $0.002 27691 $528.06 19.36 27.276 $0.008 27691 80 $84.56 3.10 27.276 $0.002 27692 $112.92 4.14 27.276 $0.008 27692 80 $18.00 0.66 27.276 $0.002 27695 $457.42 16.77 27.276 $0.008 27695 80 $73.10 2.68 27.276 $0.002 27696 $458.24 16.80 27.276 $0.008 27696 80 $73.37 2.69 27.276 $0.002 27698 $618.89 22.69 27.276 $0.008 27698 80 $99.01 3.63 27.276 $0.002 27700 $639.89 23.46 27.276 $0.008 27700 80 $102.29 3.75 27.276 $0.002 27702 $1,182.96 43.37 27.276 $0.008 27702 80 $189.30 6.94 27.276 $0.002 27703 $878.01 32.19 27.276 $0.008 27703 80 $140.47 5.15 27.276 $0.002 27704 $403.14 14.78 27.276 $0.002 27760 $165.29 6.06 27.276 $0.002 27762 $249.03 9.13 27.276 $0.002 27766 $480.88 17.63 27.276 $0.008 27766 80 $76.92 2.82 27.276 $0.002 27786 $159.56 5.85 27.276 $0.002 27788 $231.03 8.47 27.276 $0.002 27792 $448.14 16.43 27.276 $0.008 27792 80 $71.74 2.63 27.276 $0.002 27808 $167.20 6.13 27.276 $0.002 27810 $306.58 11.24 27.276 $0.002 27814 $616.98 22.62 27.276 $0.008 27814 80 $98.74 3.62 27.276 $0.002 27816 $204.02 7.48 27.276 $0.002 27818 $368.23 13.50 27.276 $0.002 27822 $631.71 23.16 27.276 $0.008 27822 80 $101.19 3.71 27.276 $0.002 27823 $739.73 27.12 27.276 $0.008 27823 80 $118.38 4.34 27.276 $0.002 27824 $198.30 7.27 27.276 $0.002 27825 $357.86 13.12 27.276 $0.002 27826 $576.34 21.13 27.276 $0.008 27826 80 $92.19 3.38 27.276 $0.002 27827 $592.16 21.71 27.276 $0.008 27827 80 $94.65 3.47 27.276 $0.002 27828 $690.36 25.31 27.276 $0.008 27828 80 $110.47 4.05 27.276 $0.002 27829 $414.32 15.19 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 5: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

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TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

8 27829 80 $66.28 2.43 27.276 $0.002 27840 $182.48 6.69 27.276 $0.002 27842 $237.85 8.72 27.276 $0.002 27846 $546.34 20.03 27.276 $0.008 27846 80 $87.28 3.20 27.276 $0.002 27848 $578.80 21.22 27.276 $0.008 27848 80 $92.74 3.40 27.276 $0.002 27860 $112.65 4.13 27.276 $0.002 27870 $763.46 27.99 27.276 $0.008 27870 80 $122.20 4.48 27.276 $0.002 27888 $570.89 20.93 27.276 $0.008 27888 80 $91.37 3.35 27.276 $0.002 27889 $540.61 19.82 27.276 $0.002 28001 $93.83 3.44 27.276 $0.002 28002 $182.20 6.68 27.276 $0.002 28003 $333.04 12.21 27.276 $0.002 28005 $354.86 13.01 27.276 $0.002 28008 $205.93 7.55 27.276 $0.002 28010 $198.84 7.29 27.276 $0.002 28011 $170.75 6.26 27.276 $0.002 28020 $279.31 10.24 27.276 $0.002 28022 $214.39 7.86 27.276 $0.002 28024 $193.93 7.11 27.276 $0.002 28030 $291.03 10.67 27.276 $0.002 28035 $358.41 13.14 27.276 $0.008 28035 80 $57.28 2.10 27.276 $0.002 28043 $153.56 5.63 27.276 $0.002 28045 $256.12 9.39 27.276 $0.002 28046 $447.05 16.39 27.276 $0.002 28050 $239.48 8.78 27.276 $0.002 28052 $228.30 8.37 27.276 $0.002 28054 $164.47 6.03 27.276 $0.002 28060 $282.31 10.35 27.276 $0.002 28062 $406.69 14.91 27.276 $0.008 28062 80 $65.19 2.39 27.276 $0.002 28070 $278.49 10.21 27.276 $0.002 28072 $228.57 8.38 27.276 $0.002 28080 $225.57 8.27 27.276 $0.002 28086 $268.40 9.84 27.276 $0.002 28088 $219.84 8.06 27.276 $0.002 28090 $217.66 7.98 27.276 $0.002 28092 $165.84 6.08 27.276 $0.002 28100 $302.22 11.08 27.276 $0.008 28100 80 $48.28 1.77 27.276 $0.002 28104 $278.22 10.20 27.276 $0.008 28104 80 $44.46 1.63 27.276 $0.002 28108 $246.58 9.04 27.276 $0.002 28110 $220.94 8.10 27.276 $0.008 28110 80 $35.46 1.30 27.276 $0.002 28111 $297.31 10.90 27.276 $0.002 28112 $248.21 9.10 27.276 $0.002 28113 $259.12 9.50 27.276 $0.002 28114 $541.16 19.84 27.276 $0.002 28116 $351.31 12.88 27.276 $0.002 28118 $342.86 12.57 27.276 $0.008 28118 80 $54.82 2.01 27.276 $0.002 28119 $319.67 11.72 27.276 $0.008 28119 80 $51.28 1.88 27.276 $0.002 28120 $353.22 12.95 27.276 $0.002 28122 $334.68 12.27 27.276 $0.002 28124 $254.76 9.34 27.276 $0.008 28124 80 $40.64 1.49 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 6: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

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TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

2 28126 $222.03 8.14 27.276 $0.002 28130 $438.05 16.06 27.276 $0.008 28130 80 $70.10 2.57 27.276 $0.002 28140 $345.04 12.65 27.276 $0.002 28150 $215.48 7.90 27.276 $0.002 28153 $222.57 8.16 27.276 $0.002 28160 $232.39 8.52 27.276 $0.002 28171 $513.06 18.81 27.276 $0.008 28171 80 $82.10 3.01 27.276 $0.002 28173 $468.06 17.16 27.276 $0.002 28175 $326.49 11.97 27.276 $0.002 28190 $71.74 2.63 27.276 $0.002 28192 $192.02 7.04 27.276 $0.002 28193 $233.21 8.55 27.276 $0.002 28200 $288.03 10.56 27.276 $0.002 28208 $206.75 7.58 27.276 $0.002 28220 $246.30 9.03 27.276 $0.002 28222 $319.13 11.70 27.276 $0.002 28225 $173.75 6.37 27.276 $0.002 28226 $231.85 8.50 27.276 $0.002 28230 $190.93 7.00 27.276 $0.002 28232 $144.02 5.28 27.276 $0.002 28234 $139.38 5.11 27.276 $0.002 28238 $441.05 16.17 27.276 $0.008 28238 80 $70.64 2.59 27.276 $0.002 28240 $186.02 6.82 27.276 $0.002 28250 $305.49 11.20 27.276 $0.002 28260 $356.77 13.08 27.276 $0.002 28261 $443.24 16.25 27.276 $0.002 28262 $734.27 26.92 27.276 $0.008 28262 80 $117.56 4.31 27.276 $0.002 28264 $590.25 21.64 27.276 $0.002 28270 $213.57 7.83 27.276 $0.002 28272 $169.38 6.21 27.276 $0.002 28280 $213.84 7.84 27.276 $0.002 28285 $239.76 8.79 27.276 $0.002 28286 $240.57 8.82 27.276 $0.002 28288 $227.21 8.33 27.276 $0.002 28289 $279.31 10.24 27.276 $0.008 28289 80 $44.73 1.64 27.276 $0.002 28290 $326.77 11.98 27.276 $0.008 28290 80 $52.37 1.92 27.276 $0.002 28292 $403.14 14.78 27.276 $0.008 28292 80 $64.37 2.36 27.276 $0.002 28293 $539.79 19.79 27.276 $0.008 28293 80 $86.46 3.17 27.276 $0.002 28294 $522.06 19.14 27.276 $0.008 28294 80 $83.46 3.06 27.276 $0.002 28296 $531.61 19.49 27.276 $0.008 28296 80 $85.10 3.12 27.276 $0.002 28297 $538.97 19.76 27.276 $0.008 28297 80 $86.19 3.16 27.276 $0.002 28298 $494.24 18.12 27.276 $0.008 28298 80 $79.10 2.90 27.276 $0.002 28299 $565.43 20.73 27.276 $0.008 28299 80 $90.56 3.32 27.276 $0.002 28300 $472.15 17.31 27.276 $0.008 28300 80 $75.55 2.77 27.276 $0.002 28302 $549.88 20.16 27.276 $0.008 28302 80 $88.10 3.23 27.276 $0.002 28304 $454.69 16.67 27.276 $0.008 28304 80 $72.83 2.67 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 7: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

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TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

7 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

2 28306 $309.04 11.33 27.276 $0.008 28306 80 $49.37 1.81 27.276 $0.002 28307 $364.41 13.36 27.276 $0.002 28308 $325.13 11.92 27.276 $0.008 28308 80 $52.10 1.91 27.276 $0.002 28309 $480.06 17.60 27.276 $0.002 28310 $277.67 10.18 27.276 $0.002 28312 $267.58 9.81 27.276 $0.002 28313 $219.03 8.03 27.276 $0.002 28315 $265.67 9.74 27.276 $0.002 28320 $531.34 19.48 27.276 $0.008 28320 80 $85.10 3.12 27.276 $0.002 28322 $380.50 13.95 27.276 $0.008 28322 80 $60.83 2.23 27.276 $0.002 28340 $397.41 14.57 27.276 $0.002 28341 $473.51 17.36 27.276 $0.002 28344 $235.39 8.63 27.276 $0.008 28344 80 $37.64 1.38 27.276 $0.002 28345 $324.04 11.88 27.276 $0.002 28360 $0.00 0.00 0.000 $355.252 28400 $148.38 5.44 27.276 $0.002 28405 $252.03 9.24 27.276 $0.002 28406 $369.04 13.53 27.276 $0.002 28415 $568.98 20.86 27.276 $0.008 28415 80 $91.10 3.34 27.276 $0.002 28420 $685.17 25.12 27.276 $0.008 28420 80 $109.65 4.02 27.276 $0.002 28430 $136.65 5.01 27.276 $0.002 28435 $204.57 7.50 27.276 $0.002 28436 $266.76 9.78 27.276 $0.002 28445 $546.07 20.02 27.276 $0.008 28445 80 $87.28 3.20 27.276 $0.002 28450 $111.29 4.08 27.276 $0.002 28455 $166.93 6.12 27.276 $0.002 28456 $144.84 5.31 27.276 $0.002 28465 $370.41 13.58 27.276 $0.002 28470 $108.56 3.98 27.276 $0.002 28475 $154.65 5.67 27.276 $0.002 28476 $188.75 6.92 27.276 $0.002 28485 $304.67 11.17 27.276 $0.008 28485 80 $48.82 1.79 27.276 $0.002 28490 $57.55 2.11 27.276 $0.002 28495 $78.01 2.86 27.276 $0.002 28496 $130.65 4.79 27.276 $0.002 28505 $200.21 7.34 27.276 $0.002 28510 $57.01 2.09 27.276 $0.002 28515 $74.19 2.72 27.276 $0.002 28525 $155.75 5.71 27.276 $0.002 28530 $60.28 2.21 27.276 $0.002 28531 $118.38 4.34 27.276 $0.002 28540 $73.65 2.70 27.276 $0.002 28545 $104.19 3.82 27.276 $0.002 28546 $174.57 6.40 27.276 $0.002 28555 $348.86 12.79 27.276 $0.008 28555 80 $55.92 2.05 27.276 $0.002 28570 $95.47 3.50 27.276 $0.002 28575 $175.38 6.43 27.276 $0.002 28576 $193.93 7.11 27.276 $0.002 28585 $373.41 13.69 27.276 $0.008 28585 80 $59.73 2.19 27.276 $0.002 28600 $72.28 2.65 27.276 $0.002 28605 $144.29 5.29 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 8: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

8 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

2 28606 $245.21 8.99 27.276 $0.002 28615 $312.58 11.46 27.276 $0.008 28615 80 $49.92 1.83 27.276 $0.002 28630 $79.92 2.93 27.276 $0.002 28635 $100.10 3.67 27.276 $0.002 28636 $157.93 5.79 27.276 $0.002 28645 $217.66 7.98 27.276 $0.008 28645 80 $34.91 1.28 27.276 $0.002 28660 $53.73 1.97 27.276 $0.002 28665 $84.56 3.10 27.276 $0.002 28666 $150.84 5.53 27.276 $0.002 28675 $161.20 5.91 27.276 $0.002 28705 $649.71 23.82 27.276 $0.008 28705 80 $103.92 3.81 27.276 $0.002 28715 $691.45 25.35 27.276 $0.008 28715 80 $110.74 4.06 27.276 $0.002 28725 $562.16 20.61 27.276 $0.008 28725 80 $90.01 3.30 27.276 $0.002 28730 $520.97 19.10 27.276 $0.008 28730 80 $83.46 3.06 27.276 $0.002 28735 $609.35 22.34 27.276 $0.008 28735 80 $97.38 3.57 27.276 $0.002 28737 $421.69 15.46 27.276 $0.008 28737 80 $67.37 2.47 27.276 $0.002 28740 $346.68 12.71 27.276 $0.008 28740 80 $55.37 2.03 27.276 $0.002 28750 $313.40 11.49 27.276 $0.008 28750 80 $50.19 1.84 27.276 $0.002 28755 $247.94 9.09 27.276 $0.008 28755 80 $39.55 1.45 27.276 $0.002 28760 $331.13 12.14 27.276 $0.008 28760 80 $52.92 1.94 27.276 $0.002 28800 $437.23 16.03 27.276 $0.008 28800 80 $69.83 2.56 27.276 $0.002 28805 $433.42 15.89 27.276 $0.008 28805 80 $69.28 2.54 27.276 $0.002 28810 $292.40 10.72 27.276 $0.002 28820 $189.84 6.96 27.276 $0.002 28825 $170.48 6.25 27.276 $0.002 28899 $0.00 0.00 0.000 $0.00 58 28899 80 $0.00 0.00 0.000 $0.00 52 29345 $73.92 2.71 27.276 $0.002 29405 $50.73 1.86 27.276 $0.002 29425 $60.55 2.22 27.276 $0.002 29440 $24.00 0.88 27.276 $0.002 29445 $102.56 3.76 27.276 $0.002 29450 $41.46 1.52 27.276 $0.002 29515 $36.28 1.33 27.276 $0.002 29540 $24.28 0.89 27.276 $0.002 29550 $22.37 0.82 27.276 $0.002 29580 $26.46 0.97 27.276 $0.002 29590 $30.55 1.12 27.276 $0.002 29700 $35.73 1.31 27.276 $0.002 29750 $52.92 1.94 27.276 $0.002 29799 $0.00 0.00 0.000 $0.00 52 29893 $296.76 10.88 27.276 $0.002 29894 $420.87 15.43 27.276 $0.002 29895 $517.43 18.97 27.276 $0.002 29897 $562.16 20.61 27.276 $0.002 29898 $645.62 23.67 27.276 $0.002 29999 $0.00 0.00 0.000 $0.002 64450 $63.01 2.31 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 9: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

9 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

2 64704 $303.58 11.13 27.276 $0.002 64726 $136.65 5.01 27.276 $0.002 64776 $231.03 8.47 27.276 $0.002 64778 $180.02 6.60 27.276 $0.002 64782 $315.31 11.56 27.276 $0.002 64783 $214.39 7.86 27.276 $0.004 73600 $21.00 0.77 27.276 $0.00I 73600 26 $6.55 0.24 27.276 $0.00T 73600 TC $14.46 0.53 27.276 $0.004 73610 $23.18 0.85 27.276 $0.00I 73610 26 $7.36 0.27 27.276 $0.00T 73610 TC $15.82 0.58 27.276 $0.004 73620 $21.00 0.77 27.276 $0.00I 73620 26 $6.55 0.24 27.276 $0.00T 73620 TC $14.46 0.53 27.276 $0.004 73630 $23.18 0.85 27.276 $0.00I 73630 26 $7.36 0.27 27.276 $0.00T 73630 TC $15.82 0.58 27.276 $0.004 73650 $20.46 0.75 27.276 $0.00I 73650 26 $6.55 0.24 27.276 $0.00T 73650 TC $13.91 0.51 27.276 $0.004 73660 $17.73 0.65 27.276 $0.00I 73660 26 $5.46 0.20 27.276 $0.00T 73660 TC $12.27 0.45 27.276 $0.004 76880 $67.10 2.46 27.276 $0.00I 76880 26 $25.91 0.95 27.276 $0.00T 76880 TC $41.19 1.51 27.276 $0.004 76999 $0.00 0.00 0.000 $0.00 5I 76999 26 $0.00 0.00 0.000 $0.00 5T 76999 TC $0.00 0.00 0.000 $0.00 55 78267 $0.00 0.00 0.000 $10.86 25 78268 $0.00 0.00 0.000 $93.09 25 80048 $0.00 0.00 0.000 $11.70 25 80050 $0.00 0.00 0.000 $48.56 25 80051 $0.00 0.00 0.000 $9.69 25 80053 $0.00 0.00 0.000 $14.61 25 80055 $0.00 0.00 0.000 $41.89 25 80061 $0.00 0.00 0.000 $18.51 25 80069 $0.00 0.00 0.000 $12.00 25 80074 $0.00 0.00 0.000 $65.82 25 80076 $0.00 0.00 0.000 $11.29 25 80100 $0.00 0.00 0.000 $15.36 25 80101 $0.00 0.00 0.000 $19.03 25 80102 $0.00 0.00 0.000 $18.31 25 80150 $0.00 0.00 0.000 $20.83 25 80152 $0.00 0.00 0.000 $24.74 25 80154 $0.00 0.00 0.000 $25.56 25 80156 $0.00 0.00 0.000 $20.12 25 80157 $0.00 0.00 0.000 $13.74 25 80158 $0.00 0.00 0.000 $24.95 25 80160 $0.00 0.00 0.000 $23.79 25 80162 $0.00 0.00 0.000 $18.35 25 80164 $0.00 0.00 0.000 $18.72 25 80166 $0.00 0.00 0.000 $21.42 25 80168 $0.00 0.00 0.000 $18.78 25 80170 $0.00 0.00 0.000 $22.65 25 80172 $0.00 0.00 0.000 $22.52 25 80173 $0.00 0.00 0.000 $20.12 25 80174 $0.00 0.00 0.000 $23.79 25 80176 $0.00 0.00 0.000 $20.30 25 80178 $0.00 0.00 0.000 $9.13 25 80182 $0.00 0.00 0.000 $18.72 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 10: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

10 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 80184 $0.00 0.00 0.000 $15.83 25 80185 $0.00 0.00 0.000 $18.32 25 80186 $0.00 0.00 0.000 $19.03 25 80188 $0.00 0.00 0.000 $22.93 25 80190 $0.00 0.00 0.000 $23.15 25 80192 $0.00 0.00 0.000 $23.15 25 80194 $0.00 0.00 0.000 $20.17 25 80196 $0.00 0.00 0.000 $9.81 25 80197 $0.00 0.00 0.000 $18.97 25 80198 $0.00 0.00 0.000 $19.56 25 80200 $0.00 0.00 0.000 $22.27 25 80201 $0.00 0.00 0.000 $16.48 25 80202 $0.00 0.00 0.000 $18.72 25 80299 $0.00 0.00 0.000 $18.92 25 80400 $0.00 0.00 0.000 $45.06 25 80402 $0.00 0.00 0.000 $120.14 25 80406 $0.00 0.00 0.000 $107.30 25 80408 $0.00 0.00 0.000 $173.44 25 80410 $0.00 0.00 0.000 $111.03 25 80412 $0.00 0.00 0.000 $455.46 25 80414 $0.00 0.00 0.000 $71.36 25 80415 $0.00 0.00 0.000 $77.24 25 80416 $0.00 0.00 0.000 $182.40 25 80417 $0.00 0.00 0.000 $60.80 25 80418 $0.00 0.00 0.000 $800.92 25 80420 $0.00 0.00 0.000 $99.54 25 80422 $0.00 0.00 0.000 $63.69 25 80424 $0.00 0.00 0.000 $69.80 25 80426 $0.00 0.00 0.000 $205.16 25 80428 $0.00 0.00 0.000 $92.16 25 80430 $0.00 0.00 0.000 $108.42 25 80432 $0.00 0.00 0.000 $186.66 25 80434 $0.00 0.00 0.000 $139.75 25 80435 $0.00 0.00 0.000 $142.30 25 80436 $0.00 0.00 0.000 $102.38 25 80438 $0.00 0.00 0.000 $69.63 25 80439 $0.00 0.00 0.000 $92.84 25 80440 $0.00 0.00 0.000 $80.34 25 81000 $0.00 0.00 0.000 $4.37 25 81001 $0.00 0.00 0.000 $4.37 25 81002 $0.00 0.00 0.000 $3.54 25 81003 $0.00 0.00 0.000 $3.10 25 81005 $0.00 0.00 0.000 $3.00 25 81015 $0.00 0.00 0.000 $4.20 25 81020 $0.00 0.00 0.000 $5.09 25 81025 $0.00 0.00 0.000 $8.74 25 81050 $0.00 0.00 0.000 $4.14 25 81099 $0.00 0.00 0.000 $0.00 55 82000 $0.00 0.00 0.000 $17.12 25 82003 $0.00 0.00 0.000 $27.96 25 82009 $0.00 0.00 0.000 $6.02 25 82010 $0.00 0.00 0.000 $10.12 25 82013 $0.00 0.00 0.000 $9.77 25 82016 $0.00 0.00 0.000 $18.38 25 82017 $0.00 0.00 0.000 $13.78 25 82024 $0.00 0.00 0.000 $53.38 25 82030 $0.00 0.00 0.000 $28.03 25 82040 $0.00 0.00 0.000 $6.85 25 82042 $0.00 0.00 0.000 $7.15 25 82043 $0.00 0.00 0.000 $7.70 25 82044 $0.00 0.00 0.000 $6.33 25 82055 $0.00 0.00 0.000 $14.93 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 11: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

11 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 82075 $0.00 0.00 0.000 $16.66 25 82085 $0.00 0.00 0.000 $13.42 25 82088 $0.00 0.00 0.000 $56.32 25 82101 $0.00 0.00 0.000 $41.48 25 82103 $0.00 0.00 0.000 $18.56 25 82104 $0.00 0.00 0.000 $19.98 25 82105 $0.00 0.00 0.000 $23.18 25 82106 $0.00 0.00 0.000 $23.18 25 82108 $0.00 0.00 0.000 $35.22 25 82120 $0.00 0.00 0.000 $5.19 25 82127 $0.00 0.00 0.000 $18.38 25 82128 $0.00 0.00 0.000 $18.38 25 82131 $0.00 0.00 0.000 $13.78 25 82135 $0.00 0.00 0.000 $22.75 25 82136 $0.00 0.00 0.000 $13.78 25 82139 $0.00 0.00 0.000 $13.78 25 82140 $0.00 0.00 0.000 $20.14 25 82143 $0.00 0.00 0.000 $9.50 25 82145 $0.00 0.00 0.000 $21.48 25 82150 $0.00 0.00 0.000 $8.96 25 82154 $0.00 0.00 0.000 $39.85 25 82157 $0.00 0.00 0.000 $40.46 25 82160 $0.00 0.00 0.000 $34.57 25 82163 $0.00 0.00 0.000 $12.09 25 82164 $0.00 0.00 0.000 $20.17 25 82172 $0.00 0.00 0.000 $21.41 25 82175 $0.00 0.00 0.000 $26.22 25 82180 $0.00 0.00 0.000 $13.66 25 82190 $0.00 0.00 0.000 $20.60 25 82205 $0.00 0.00 0.000 $15.83 25 82232 $0.00 0.00 0.000 $22.36 25 82239 $0.00 0.00 0.000 $23.67 25 82240 $0.00 0.00 0.000 $36.73 25 82247 $0.00 0.00 0.000 $6.94 25 82248 $0.00 0.00 0.000 $6.94 25 82252 $0.00 0.00 0.000 $6.28 25 82261 $0.00 0.00 0.000 $13.78 25 82270 $0.00 0.00 0.000 $4.49 25 82274 $0.00 0.00 0.000 $4.49 25 82286 $0.00 0.00 0.000 $9.52 25 82300 $0.00 0.00 0.000 $31.98 25 82306 $0.00 0.00 0.000 $37.55 25 82307 $0.00 0.00 0.000 $44.53 25 82308 $0.00 0.00 0.000 $37.01 25 82310 $0.00 0.00 0.000 $7.12 25 82330 $0.00 0.00 0.000 $18.88 25 82331 $0.00 0.00 0.000 $7.15 25 82340 $0.00 0.00 0.000 $8.34 25 82355 $0.00 0.00 0.000 $15.99 25 82360 $0.00 0.00 0.000 $17.80 25 82365 $0.00 0.00 0.000 $17.82 25 82370 $0.00 0.00 0.000 $17.32 25 82373 $0.00 0.00 0.000 $9.95 25 82374 $0.00 0.00 0.000 $6.76 25 82375 $0.00 0.00 0.000 $17.03 25 82376 $0.00 0.00 0.000 $8.28 25 82378 $0.00 0.00 0.000 $26.22 25 82379 $0.00 0.00 0.000 $13.78 25 82380 $0.00 0.00 0.000 $12.75 25 82382 $0.00 0.00 0.000 $23.76 25 82383 $0.00 0.00 0.000 $34.63 25 82384 $0.00 0.00 0.000 $34.90 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 12: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

12 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 82387 $0.00 0.00 0.000 $18.38 25 82390 $0.00 0.00 0.000 $14.84 25 82397 $0.00 0.00 0.000 $19.53 25 82415 $0.00 0.00 0.000 $17.51 25 82435 $0.00 0.00 0.000 $6.35 25 82436 $0.00 0.00 0.000 $6.95 25 82438 $0.00 0.00 0.000 $6.76 25 82441 $0.00 0.00 0.000 $8.30 25 82465 $0.00 0.00 0.000 $6.02 25 82480 $0.00 0.00 0.000 $10.89 25 82482 $0.00 0.00 0.000 $10.62 25 82485 $0.00 0.00 0.000 $28.54 25 82486 $0.00 0.00 0.000 $24.96 25 82487 $0.00 0.00 0.000 $22.06 25 82488 $0.00 0.00 0.000 $29.53 25 82489 $0.00 0.00 0.000 $25.56 25 82491 $0.00 0.00 0.000 $24.96 25 82495 $0.00 0.00 0.000 $28.03 25 82507 $0.00 0.00 0.000 $38.43 25 82520 $0.00 0.00 0.000 $20.94 25 82523 $0.00 0.00 0.000 $25.83 25 82525 $0.00 0.00 0.000 $17.15 25 82528 $0.00 0.00 0.000 $31.11 25 82530 $0.00 0.00 0.000 $23.10 25 82533 $0.00 0.00 0.000 $22.53 25 82540 $0.00 0.00 0.000 $6.40 25 82543 $0.00 0.00 0.000 $24.96 25 82544 $0.00 0.00 0.000 $24.96 25 82550 $0.00 0.00 0.000 $9.01 25 82552 $0.00 0.00 0.000 $18.51 25 82553 $0.00 0.00 0.000 $8.50 25 82554 $0.00 0.00 0.000 $8.50 25 82565 $0.00 0.00 0.000 $7.07 25 82570 $0.00 0.00 0.000 $7.15 25 82575 $0.00 0.00 0.000 $13.06 25 82585 $0.00 0.00 0.000 $11.85 25 82595 $0.00 0.00 0.000 $8.95 25 82600 $0.00 0.00 0.000 $26.81 25 82607 $0.00 0.00 0.000 $20.83 25 82608 $0.00 0.00 0.000 $19.80 25 82615 $0.00 0.00 0.000 $11.29 25 82626 $0.00 0.00 0.000 $34.93 25 82627 $0.00 0.00 0.000 $30.72 25 82633 $0.00 0.00 0.000 $28.66 25 82634 $0.00 0.00 0.000 $28.66 25 82638 $0.00 0.00 0.000 $16.92 25 82646 $0.00 0.00 0.000 $28.54 25 82649 $0.00 0.00 0.000 $35.52 25 82651 $0.00 0.00 0.000 $35.68 25 82652 $0.00 0.00 0.000 $53.19 25 82654 $0.00 0.00 0.000 $19.14 25 82658 $0.00 0.00 0.000 $24.96 25 82664 $0.00 0.00 0.000 $36.14 25 82666 $0.00 0.00 0.000 $27.26 25 82668 $0.00 0.00 0.000 $25.97 25 82670 $0.00 0.00 0.000 $38.62 25 82671 $0.00 0.00 0.000 $44.64 25 82672 $0.00 0.00 0.000 $12.09 25 82677 $0.00 0.00 0.000 $33.43 25 82679 $0.00 0.00 0.000 $34.50 25 82690 $0.00 0.00 0.000 $23.89 25 82693 $0.00 0.00 0.000 $20.59 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 13: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

13 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 82696 $0.00 0.00 0.000 $32.60 25 82705 $0.00 0.00 0.000 $7.04 25 82710 $0.00 0.00 0.000 $23.21 25 82715 $0.00 0.00 0.000 $23.53 25 82725 $0.00 0.00 0.000 $18.40 25 82726 $0.00 0.00 0.000 $24.96 25 82728 $0.00 0.00 0.000 $18.83 25 82731 $0.00 0.00 0.000 $89.995 82735 $0.00 0.00 0.000 $25.63 25 82742 $0.00 0.00 0.000 $27.36 25 82746 $0.00 0.00 0.000 $20.32 25 82747 $0.00 0.00 0.000 $23.89 25 82757 $0.00 0.00 0.000 $23.97 25 82759 $0.00 0.00 0.000 $12.47 25 82760 $0.00 0.00 0.000 $15.47 25 82775 $0.00 0.00 0.000 $29.11 25 82776 $0.00 0.00 0.000 $11.32 25 82784 $0.00 0.00 0.000 $12.85 25 82785 $0.00 0.00 0.000 $22.76 25 82787 $0.00 0.00 0.000 $5.79 25 82800 $0.00 0.00 0.000 $11.71 25 82803 $0.00 0.00 0.000 $26.74 25 82805 $0.00 0.00 0.000 $39.21 25 82810 $0.00 0.00 0.000 $12.06 25 82820 $0.00 0.00 0.000 $13.82 25 82926 $0.00 0.00 0.000 $7.53 25 82928 $0.00 0.00 0.000 $9.05 25 82938 $0.00 0.00 0.000 $24.46 25 82941 $0.00 0.00 0.000 $24.38 25 82943 $0.00 0.00 0.000 $12.09 25 82945 $0.00 0.00 0.000 $5.42 25 82946 $0.00 0.00 0.000 $18.78 25 82947 $0.00 0.00 0.000 $5.42 25 82948 $0.00 0.00 0.000 $4.37 25 82950 $0.00 0.00 0.000 $6.56 25 82951 $0.00 0.00 0.000 $17.80 25 82952 $0.00 0.00 0.000 $5.42 25 82953 $0.00 0.00 0.000 $20.93 25 82955 $0.00 0.00 0.000 $12.09 25 82960 $0.00 0.00 0.000 $8.38 25 82963 $0.00 0.00 0.000 $29.69 25 82965 $0.00 0.00 0.000 $10.68 25 82975 $0.00 0.00 0.000 $21.88 25 82977 $0.00 0.00 0.000 $9.95 25 82978 $0.00 0.00 0.000 $19.70 25 82979 $0.00 0.00 0.000 $9.39 25 82980 $0.00 0.00 0.000 $25.32 25 82985 $0.00 0.00 0.000 $20.83 25 83001 $0.00 0.00 0.000 $25.69 25 83002 $0.00 0.00 0.000 $25.60 25 83003 $0.00 0.00 0.000 $23.04 25 83008 $0.00 0.00 0.000 $23.20 25 83009 $0.00 0.00 0.000 $93.095 83010 $0.00 0.00 0.000 $17.38 25 83012 $0.00 0.00 0.000 $23.76 25 83013 $0.00 0.00 0.000 $93.09 25 83014 $0.00 0.00 0.000 $10.86 25 83015 $0.00 0.00 0.000 $26.03 25 83018 $0.00 0.00 0.000 $30.35 25 83020 $0.00 0.00 0.000 $17.80 25 83021 $0.00 0.00 0.000 $24.96 25 83026 $0.00 0.00 0.000 $3.26 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 14: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

14 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 83030 $0.00 0.00 0.000 $11.43 25 83033 $0.00 0.00 0.000 $8.24 25 83036 $0.00 0.00 0.000 $13.42 25 83045 $0.00 0.00 0.000 $3.98 25 83050 $0.00 0.00 0.000 $4.07 25 83051 $0.00 0.00 0.000 $10.10 25 83055 $0.00 0.00 0.000 $6.80 25 83060 $0.00 0.00 0.000 $7.97 25 83065 $0.00 0.00 0.000 $9.52 25 83068 $0.00 0.00 0.000 $9.39 25 83069 $0.00 0.00 0.000 $5.45 25 83070 $0.00 0.00 0.000 $6.56 25 83071 $0.00 0.00 0.000 $9.50 25 83080 $0.00 0.00 0.000 $13.78 25 83088 $0.00 0.00 0.000 $40.81 25 83090 $0.00 0.00 0.000 $23.31 25 83150 $0.00 0.00 0.000 $14.40 25 83491 $0.00 0.00 0.000 $24.21 25 83497 $0.00 0.00 0.000 $6.43 25 83498 $0.00 0.00 0.000 $37.54 25 83499 $0.00 0.00 0.000 $34.83 25 83500 $0.00 0.00 0.000 $31.30 25 83505 $0.00 0.00 0.000 $33.59 25 83516 $0.00 0.00 0.000 $15.95 25 83518 $0.00 0.00 0.000 $11.72 25 83519 $0.00 0.00 0.000 $18.67 25 83520 $0.00 0.00 0.000 $17.89 25 83525 $0.00 0.00 0.000 $15.81 25 83527 $0.00 0.00 0.000 $17.90 25 83528 $0.00 0.00 0.000 $21.98 25 83540 $0.00 0.00 0.000 $8.95 25 83550 $0.00 0.00 0.000 $12.08 25 83570 $0.00 0.00 0.000 $12.22 25 83582 $0.00 0.00 0.000 $19.59 25 83586 $0.00 0.00 0.000 $17.69 25 83593 $0.00 0.00 0.000 $30.31 25 83605 $0.00 0.00 0.000 $14.76 25 83615 $0.00 0.00 0.000 $8.35 25 83625 $0.00 0.00 0.000 $17.69 25 83632 $0.00 0.00 0.000 $27.93 25 83633 $0.00 0.00 0.000 $6.43 25 83634 $0.00 0.00 0.000 $3.98 25 83655 $0.00 0.00 0.000 $16.72 25 83661 $0.00 0.00 0.000 $30.38 25 83662 $0.00 0.00 0.000 $26.14 25 83663 $0.00 0.00 0.000 $13.07 25 83664 $0.00 0.00 0.000 $6.53 25 83670 $0.00 0.00 0.000 $12.66 25 83690 $0.00 0.00 0.000 $9.52 25 83718 $0.00 0.00 0.000 $11.31 25 83721 $0.00 0.00 0.000 $13.18 25 83727 $0.00 0.00 0.000 $23.76 25 83735 $0.00 0.00 0.000 $9.26 25 83775 $0.00 0.00 0.000 $10.19 25 83785 $0.00 0.00 0.000 $33.98 25 83788 $0.00 0.00 0.000 $24.96 25 83789 $0.00 0.00 0.000 $24.96 25 83805 $0.00 0.00 0.000 $24.36 25 83825 $0.00 0.00 0.000 $17.92 25 83835 $0.00 0.00 0.000 $23.41 25 83840 $0.00 0.00 0.000 $22.56 25 83857 $0.00 0.00 0.000 $14.84 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 15: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

15 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 83858 $0.00 0.00 0.000 $9.39 25 83864 $0.00 0.00 0.000 $27.51 25 83866 $0.00 0.00 0.000 $13.25 25 83872 $0.00 0.00 0.000 $8.10 25 83873 $0.00 0.00 0.000 $23.78 25 83874 $0.00 0.00 0.000 $17.84 25 83880 $0.00 0.00 0.000 $47.43 25 83883 $0.00 0.00 0.000 $18.79 25 83885 $0.00 0.00 0.000 $33.86 25 83887 $0.00 0.00 0.000 $32.73 25 83890 $0.00 0.00 0.000 $5.54 25 83891 $0.00 0.00 0.000 $5.54 25 83892 $0.00 0.00 0.000 $5.54 25 83893 $0.00 0.00 0.000 $5.54 25 83894 $0.00 0.00 0.000 $5.54 25 83896 $0.00 0.00 0.000 $5.54 25 83897 $0.00 0.00 0.000 $5.54 25 83898 $0.00 0.00 0.000 $14.07 25 83901 $0.00 0.00 0.000 $14.07 25 83902 $0.00 0.00 0.000 $14.07 25 83903 $0.00 0.00 0.000 $14.07 25 83904 $0.00 0.00 0.000 $14.07 25 83905 $0.00 0.00 0.000 $14.07 25 83906 $0.00 0.00 0.000 $14.07 25 83912 $0.00 0.00 0.000 $5.54 25 83915 $0.00 0.00 0.000 $15.41 25 83916 $0.00 0.00 0.000 $27.79 25 83918 $0.00 0.00 0.000 $22.75 25 83919 $0.00 0.00 0.000 $22.75 25 83921 $0.00 0.00 0.000 $22.75 25 83925 $0.00 0.00 0.000 $26.89 25 83930 $0.00 0.00 0.000 $6.81 25 83935 $0.00 0.00 0.000 $6.81 25 83937 $0.00 0.00 0.000 $39.35 25 83945 $0.00 0.00 0.000 $17.80 25 83950 $0.00 0.00 0.000 $89.01 25 83970 $0.00 0.00 0.000 $57.04 25 83986 $0.00 0.00 0.000 $4.95 25 83992 $0.00 0.00 0.000 $20.31 25 84022 $0.00 0.00 0.000 $15.70 25 84030 $0.00 0.00 0.000 $7.61 25 84035 $0.00 0.00 0.000 $2.81 25 84060 $0.00 0.00 0.000 $10.20 25 84066 $0.00 0.00 0.000 $13.35 25 84075 $0.00 0.00 0.000 $7.15 25 84078 $0.00 0.00 0.000 $10.09 25 84080 $0.00 0.00 0.000 $12.09 25 84081 $0.00 0.00 0.000 $22.84 25 84085 $0.00 0.00 0.000 $9.32 25 84087 $0.00 0.00 0.000 $14.27 25 84100 $0.00 0.00 0.000 $6.56 25 84105 $0.00 0.00 0.000 $7.15 25 84106 $0.00 0.00 0.000 $5.92 25 84110 $0.00 0.00 0.000 $11.68 25 84119 $0.00 0.00 0.000 $11.90 25 84120 $0.00 0.00 0.000 $20.33 25 84126 $0.00 0.00 0.000 $35.20 25 84127 $0.00 0.00 0.000 $16.10 25 84132 $0.00 0.00 0.000 $6.35 25 84133 $0.00 0.00 0.000 $5.94 25 84134 $0.00 0.00 0.000 $11.66 25 84135 $0.00 0.00 0.000 $26.44 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 16: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

16 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 84138 $0.00 0.00 0.000 $24.11 25 84140 $0.00 0.00 0.000 $28.58 25 84143 $0.00 0.00 0.000 $31.12 25 84144 $0.00 0.00 0.000 $28.83 25 84146 $0.00 0.00 0.000 $26.78 25 84150 $0.00 0.00 0.000 $34.50 25 84152 $0.00 0.00 0.000 $25.42 25 84153 $0.00 0.00 0.000 $25.42 25 84154 $0.00 0.00 0.000 $25.42 25 84155 $0.00 0.00 0.000 $5.06 25 84156 $0.00 0.00 0.000 $5.065 84157 $0.00 0.00 0.000 $5.065 84160 $0.00 0.00 0.000 $7.15 25 84163 $0.00 0.00 0.000 $12.20 25 84165 $0.00 0.00 0.000 $14.84 25 84181 $0.00 0.00 0.000 $23.54 25 84182 $0.00 0.00 0.000 $24.87 25 84202 $0.00 0.00 0.000 $12.21 25 84203 $0.00 0.00 0.000 $11.89 25 84206 $0.00 0.00 0.000 $24.62 25 84207 $0.00 0.00 0.000 $38.82 25 84210 $0.00 0.00 0.000 $15.01 25 84220 $0.00 0.00 0.000 $13.04 25 84228 $0.00 0.00 0.000 $16.08 25 84234 $0.00 0.00 0.000 $89.64 25 84235 $0.00 0.00 0.000 $72.31 25 84238 $0.00 0.00 0.000 $50.53 25 84244 $0.00 0.00 0.000 $30.40 25 84252 $0.00 0.00 0.000 $27.96 25 84255 $0.00 0.00 0.000 $35.28 25 84260 $0.00 0.00 0.000 $24.05 25 84270 $0.00 0.00 0.000 $30.03 25 84275 $0.00 0.00 0.000 $13.63 25 84285 $0.00 0.00 0.000 $32.55 25 84295 $0.00 0.00 0.000 $6.65 25 84300 $0.00 0.00 0.000 $6.72 25 84305 $0.00 0.00 0.000 $29.38 25 84307 $0.00 0.00 0.000 $25.27 25 84311 $0.00 0.00 0.000 $9.66 25 84315 $0.00 0.00 0.000 $3.46 25 84375 $0.00 0.00 0.000 $27.09 25 84392 $0.00 0.00 0.000 $6.56 25 84402 $0.00 0.00 0.000 $35.19 25 84403 $0.00 0.00 0.000 $35.68 25 84425 $0.00 0.00 0.000 $9.39 25 84430 $0.00 0.00 0.000 $12.09 25 84432 $0.00 0.00 0.000 $22.20 25 84436 $0.00 0.00 0.000 $9.50 25 84437 $0.00 0.00 0.000 $8.95 25 84439 $0.00 0.00 0.000 $12.46 25 84442 $0.00 0.00 0.000 $20.44 25 84443 $0.00 0.00 0.000 $23.21 25 84445 $0.00 0.00 0.000 $70.28 25 84446 $0.00 0.00 0.000 $19.60 25 84449 $0.00 0.00 0.000 $24.87 25 84450 $0.00 0.00 0.000 $7.14 25 84460 $0.00 0.00 0.000 $7.32 25 84466 $0.00 0.00 0.000 $12.72 25 84478 $0.00 0.00 0.000 $7.95 25 84479 $0.00 0.00 0.000 $8.95 25 84480 $0.00 0.00 0.000 $19.60 25 84481 $0.00 0.00 0.000 $23.41 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 17: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

17 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 84482 $0.00 0.00 0.000 $10.63 25 84484 $0.00 0.00 0.000 $13.60 25 84485 $0.00 0.00 0.000 $10.37 25 84488 $0.00 0.00 0.000 $10.09 25 84490 $0.00 0.00 0.000 $10.52 25 84510 $0.00 0.00 0.000 $14.38 25 84512 $0.00 0.00 0.000 $10.20 25 84520 $0.00 0.00 0.000 $5.45 25 84525 $0.00 0.00 0.000 $5.19 25 84540 $0.00 0.00 0.000 $6.56 25 84545 $0.00 0.00 0.000 $9.12 25 84550 $0.00 0.00 0.000 $6.25 25 84560 $0.00 0.00 0.000 $6.56 25 84577 $0.00 0.00 0.000 $7.97 25 84578 $0.00 0.00 0.000 $4.48 25 84580 $0.00 0.00 0.000 $7.97 25 84583 $0.00 0.00 0.000 $6.95 25 84585 $0.00 0.00 0.000 $21.42 25 84586 $0.00 0.00 0.000 $19.28 25 84588 $0.00 0.00 0.000 $46.91 25 84590 $0.00 0.00 0.000 $16.02 25 84591 $0.00 0.00 0.000 $16.02 25 84597 $0.00 0.00 0.000 $9.39 25 84600 $0.00 0.00 0.000 $22.21 25 84620 $0.00 0.00 0.000 $16.37 25 84630 $0.00 0.00 0.000 $15.74 25 84681 $0.00 0.00 0.000 $28.75 25 84702 $0.00 0.00 0.000 $12.07 25 84703 $0.00 0.00 0.000 $10.38 25 84999 $0.00 0.00 0.000 $0.00 55 85002 $0.00 0.00 0.000 $6.22 25 85007 $0.00 0.00 0.000 $4.76 25 85008 $0.00 0.00 0.000 $4.76 25 85009 $0.00 0.00 0.000 $5.14 25 85013 $0.00 0.00 0.000 $3.27 25 85014 $0.00 0.00 0.000 $3.27 25 85018 $0.00 0.00 0.000 $3.27 25 85025 $0.00 0.00 0.000 $10.74 25 85027 $0.00 0.00 0.000 $8.95 25 85041 $0.00 0.00 0.000 $4.16 25 85044 $0.00 0.00 0.000 $5.94 25 85045 $0.00 0.00 0.000 $5.54 25 85046 $0.00 0.00 0.000 $7.72 25 85048 $0.00 0.00 0.000 $3.52 25 85055 $0.00 0.00 0.000 $37.005 85060 $0.00 0.00 0.000 $21.745 85097 $42.01 1.54 27.276 $0.005 85130 $0.00 0.00 0.000 $16.44 25 85170 $0.00 0.00 0.000 $5.00 25 85175 $0.00 0.00 0.000 $6.28 25 85210 $0.00 0.00 0.000 $17.95 25 85220 $0.00 0.00 0.000 $24.39 25 85230 $0.00 0.00 0.000 $24.75 25 85240 $0.00 0.00 0.000 $8.87 25 85244 $0.00 0.00 0.000 $28.22 25 85245 $0.00 0.00 0.000 $11.32 25 85246 $0.00 0.00 0.000 $11.32 25 85247 $0.00 0.00 0.000 $11.32 25 85250 $0.00 0.00 0.000 $26.31 25 85260 $0.00 0.00 0.000 $24.75 25 85270 $0.00 0.00 0.000 $24.75 25 85280 $0.00 0.00 0.000 $26.74 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 18: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

18 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 85290 $0.00 0.00 0.000 $22.58 25 85291 $0.00 0.00 0.000 $12.28 25 85292 $0.00 0.00 0.000 $26.17 25 85293 $0.00 0.00 0.000 $26.17 25 85300 $0.00 0.00 0.000 $16.38 25 85301 $0.00 0.00 0.000 $14.95 25 85302 $0.00 0.00 0.000 $16.61 25 85303 $0.00 0.00 0.000 $19.11 25 85305 $0.00 0.00 0.000 $16.02 25 85306 $0.00 0.00 0.000 $19.07 25 85307 $0.00 0.00 0.000 $19.07 25 85335 $0.00 0.00 0.000 $17.80 25 85337 $0.00 0.00 0.000 $14.41 25 85345 $0.00 0.00 0.000 $5.94 25 85347 $0.00 0.00 0.000 $5.88 25 85348 $0.00 0.00 0.000 $5.14 25 85360 $0.00 0.00 0.000 $11.61 25 85362 $0.00 0.00 0.000 $9.52 25 85366 $0.00 0.00 0.000 $11.32 25 85370 $0.00 0.00 0.000 $12.86 25 85378 $0.00 0.00 0.000 $9.86 25 85379 $0.00 0.00 0.000 $12.86 25 85384 $0.00 0.00 0.000 $11.74 25 85385 $0.00 0.00 0.000 $11.74 25 85390 $0.00 0.00 0.000 $7.13 25 85396 $0.00 0.00 0.000 $7.135 85400 $0.00 0.00 0.000 $12.22 25 85410 $0.00 0.00 0.000 $10.66 25 85415 $0.00 0.00 0.000 $23.76 25 85420 $0.00 0.00 0.000 $9.04 25 85421 $0.00 0.00 0.000 $11.32 25 85441 $0.00 0.00 0.000 $5.81 25 85445 $0.00 0.00 0.000 $9.42 25 85460 $0.00 0.00 0.000 $10.69 25 85461 $0.00 0.00 0.000 $9.17 25 85475 $0.00 0.00 0.000 $12.26 25 85520 $0.00 0.00 0.000 $18.09 25 85525 $0.00 0.00 0.000 $16.38 25 85530 $0.00 0.00 0.000 $18.78 25 85536 $0.00 0.00 0.000 $8.95 25 85540 $0.00 0.00 0.000 $11.88 25 85547 $0.00 0.00 0.000 $11.88 25 85549 $0.00 0.00 0.000 $25.92 25 85555 $0.00 0.00 0.000 $9.24 25 85557 $0.00 0.00 0.000 $12.09 25 85576 $0.00 0.00 0.000 $29.69 25 85597 $0.00 0.00 0.000 $20.06 25 85610 $0.00 0.00 0.000 $5.43 25 85611 $0.00 0.00 0.000 $5.45 25 85612 $0.00 0.00 0.000 $9.66 25 85613 $0.00 0.00 0.000 $9.66 25 85635 $0.00 0.00 0.000 $13.61 25 85651 $0.00 0.00 0.000 $4.91 25 85652 $0.00 0.00 0.000 $3.73 25 85660 $0.00 0.00 0.000 $7.63 25 85670 $0.00 0.00 0.000 $7.98 25 85675 $0.00 0.00 0.000 $8.87 25 85705 $0.00 0.00 0.000 $11.75 25 85730 $0.00 0.00 0.000 $8.30 25 85732 $0.00 0.00 0.000 $8.95 25 85810 $0.00 0.00 0.000 $16.14 25 85999 $0.00 0.00 0.000 $0.00 5

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 19: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

19 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 86000 $0.00 0.00 0.000 $9.65 25 86001 $0.00 0.00 0.000 $6.61 25 86003 $0.00 0.00 0.000 $6.61 25 86005 $0.00 0.00 0.000 $11.02 25 86021 $0.00 0.00 0.000 $20.80 25 86022 $0.00 0.00 0.000 $13.52 25 86023 $0.00 0.00 0.000 $7.97 25 86038 $0.00 0.00 0.000 $16.70 25 86039 $0.00 0.00 0.000 $15.43 25 86060 $0.00 0.00 0.000 $10.09 25 86063 $0.00 0.00 0.000 $7.98 25 86077 $19.37 0.71 27.276 $0.005 86078 $37.10 1.36 27.276 $0.005 86079 $20.18 0.74 27.276 $0.005 86140 $0.00 0.00 0.000 $7.15 25 86141 $0.00 0.00 0.000 $17.89 25 86146 $0.00 0.00 0.000 $10.86 25 86147 $0.00 0.00 0.000 $10.86 25 86148 $0.00 0.00 0.000 $10.86 25 86155 $0.00 0.00 0.000 $22.08 25 86156 $0.00 0.00 0.000 $9.26 25 86157 $0.00 0.00 0.000 $11.14 25 86160 $0.00 0.00 0.000 $16.59 25 86161 $0.00 0.00 0.000 $16.59 25 86162 $0.00 0.00 0.000 $25.96 25 86171 $0.00 0.00 0.000 $8.87 25 86185 $0.00 0.00 0.000 $12.37 25 86215 $0.00 0.00 0.000 $18.32 25 86225 $0.00 0.00 0.000 $18.99 25 86226 $0.00 0.00 0.000 $16.73 25 86235 $0.00 0.00 0.000 $24.78 25 86243 $0.00 0.00 0.000 $28.36 25 86255 $0.00 0.00 0.000 $16.66 25 86256 $0.00 0.00 0.000 $16.66 25 86277 $0.00 0.00 0.000 $21.75 25 86280 $0.00 0.00 0.000 $11.31 25 86294 $0.00 0.00 0.000 $27.11 25 86300 $0.00 0.00 0.000 $28.76 25 86301 $0.00 0.00 0.000 $28.76 25 86304 $0.00 0.00 0.000 $28.76 25 86308 $0.00 0.00 0.000 $7.15 25 86309 $0.00 0.00 0.000 $8.95 25 86310 $0.00 0.00 0.000 $10.19 25 86316 $0.00 0.00 0.000 $28.76 25 86317 $0.00 0.00 0.000 $20.72 25 86318 $0.00 0.00 0.000 $17.89 25 86320 $0.00 0.00 0.000 $30.98 25 86325 $0.00 0.00 0.000 $30.90 25 86327 $0.00 0.00 0.000 $31.35 25 86329 $0.00 0.00 0.000 $12.73 25 86331 $0.00 0.00 0.000 $16.56 25 86332 $0.00 0.00 0.000 $33.68 25 86334 $0.00 0.00 0.000 $30.87 25 86337 $0.00 0.00 0.000 $23.91 25 86340 $0.00 0.00 0.000 $20.83 25 86341 $0.00 0.00 0.000 $23.91 25 86343 $0.00 0.00 0.000 $17.22 25 86344 $0.00 0.00 0.000 $11.04 25 86353 $0.00 0.00 0.000 $67.75 25 86359 $0.00 0.00 0.000 $52.13 25 86360 $0.00 0.00 0.000 $64.93 25 86361 $0.00 0.00 0.000 $37.00 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 20: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

20 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 86376 $0.00 0.00 0.000 $20.11 25 86378 $0.00 0.00 0.000 $27.22 25 86382 $0.00 0.00 0.000 $23.36 25 86384 $0.00 0.00 0.000 $31.065 86403 $0.00 0.00 0.000 $14.08 25 86406 $0.00 0.00 0.000 $12.41 25 86430 $0.00 0.00 0.000 $7.85 25 86431 $0.00 0.00 0.000 $7.85 25 86485 $0.00 0.00 0.000 $5.00 25 86490 $8.46 0.31 27.276 $0.005 86510 $9.00 0.33 27.276 $0.005 86580 $7.36 0.27 27.276 $0.005 86586 $0.00 0.00 0.000 $0.00 55 86590 $0.00 0.00 0.000 $15.24 25 86592 $0.00 0.00 0.000 $5.90 25 86593 $0.00 0.00 0.000 $6.09 25 86602 $0.00 0.00 0.000 $11.31 25 86603 $0.00 0.00 0.000 $11.31 25 86606 $0.00 0.00 0.000 $11.31 25 86609 $0.00 0.00 0.000 $11.31 25 86611 $0.00 0.00 0.000 $11.31 25 86612 $0.00 0.00 0.000 $11.31 25 86615 $0.00 0.00 0.000 $18.23 25 86617 $0.00 0.00 0.000 $21.40 25 86618 $0.00 0.00 0.000 $23.54 25 86619 $0.00 0.00 0.000 $18.49 25 86622 $0.00 0.00 0.000 $11.31 25 86625 $0.00 0.00 0.000 $11.31 25 86628 $0.00 0.00 0.000 $11.31 25 86631 $0.00 0.00 0.000 $11.31 25 86632 $0.00 0.00 0.000 $11.31 25 86635 $0.00 0.00 0.000 $11.31 25 86638 $0.00 0.00 0.000 $11.31 25 86641 $0.00 0.00 0.000 $11.31 25 86644 $0.00 0.00 0.000 $19.89 25 86645 $0.00 0.00 0.000 $11.31 25 86648 $0.00 0.00 0.000 $11.31 25 86651 $0.00 0.00 0.000 $11.31 25 86652 $0.00 0.00 0.000 $11.31 25 86653 $0.00 0.00 0.000 $11.31 25 86654 $0.00 0.00 0.000 $11.31 25 86658 $0.00 0.00 0.000 $11.31 25 86663 $0.00 0.00 0.000 $18.13 25 86664 $0.00 0.00 0.000 $21.14 25 86665 $0.00 0.00 0.000 $25.07 25 86666 $0.00 0.00 0.000 $11.31 25 86668 $0.00 0.00 0.000 $14.38 25 86671 $0.00 0.00 0.000 $11.31 25 86674 $0.00 0.00 0.000 $20.34 25 86677 $0.00 0.00 0.000 $11.31 25 86682 $0.00 0.00 0.000 $11.31 25 86684 $0.00 0.00 0.000 $21.90 25 86687 $0.00 0.00 0.000 $11.60 25 86688 $0.00 0.00 0.000 $13.79 25 86689 $0.00 0.00 0.000 $26.75 25 86692 $0.00 0.00 0.000 $23.72 25 86694 $0.00 0.00 0.000 $19.89 25 86695 $0.00 0.00 0.000 $18.23 25 86696 $0.00 0.00 0.000 $26.75 25 86698 $0.00 0.00 0.000 $11.31 25 86701 $0.00 0.00 0.000 $12.28 25 86702 $0.00 0.00 0.000 $14.59 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 21: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

21 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 86703 $0.00 0.00 0.000 $18.96 25 86704 $0.00 0.00 0.000 $16.66 25 86705 $0.00 0.00 0.000 $16.27 25 86706 $0.00 0.00 0.000 $14.84 25 86707 $0.00 0.00 0.000 $15.98 25 86708 $0.00 0.00 0.000 $17.12 25 86709 $0.00 0.00 0.000 $15.55 25 86710 $0.00 0.00 0.000 $18.74 25 86713 $0.00 0.00 0.000 $21.15 25 86717 $0.00 0.00 0.000 $11.31 25 86720 $0.00 0.00 0.000 $11.31 25 86723 $0.00 0.00 0.000 $11.31 25 86727 $0.00 0.00 0.000 $11.31 25 86729 $0.00 0.00 0.000 $11.31 25 86732 $0.00 0.00 0.000 $18.23 25 86735 $0.00 0.00 0.000 $18.03 25 86738 $0.00 0.00 0.000 $18.31 25 86741 $0.00 0.00 0.000 $11.31 25 86744 $0.00 0.00 0.000 $11.31 25 86747 $0.00 0.00 0.000 $20.77 25 86750 $0.00 0.00 0.000 $18.23 25 86753 $0.00 0.00 0.000 $11.31 25 86756 $0.00 0.00 0.000 $11.31 25 86757 $0.00 0.00 0.000 $26.75 25 86759 $0.00 0.00 0.000 $18.23 25 86762 $0.00 0.00 0.000 $19.89 25 86765 $0.00 0.00 0.000 $17.81 25 86768 $0.00 0.00 0.000 $11.31 25 86771 $0.00 0.00 0.000 $18.23 25 86774 $0.00 0.00 0.000 $20.45 25 86777 $0.00 0.00 0.000 $19.89 25 86778 $0.00 0.00 0.000 $17.65 25 86781 $0.00 0.00 0.000 $12.09 25 86784 $0.00 0.00 0.000 $11.31 25 86787 $0.00 0.00 0.000 $11.31 25 86790 $0.00 0.00 0.000 $11.31 25 86793 $0.00 0.00 0.000 $11.31 25 86800 $0.00 0.00 0.000 $21.98 25 86803 $0.00 0.00 0.000 $19.73 25 86804 $0.00 0.00 0.000 $21.40 25 86805 $0.00 0.00 0.000 $72.26 25 86806 $0.00 0.00 0.000 $65.76 25 86807 $0.00 0.00 0.000 $54.69 25 86808 $0.00 0.00 0.000 $41.02 25 86812 $0.00 0.00 0.000 $35.66 25 86813 $0.00 0.00 0.000 $71.74 25 86816 $0.00 0.00 0.000 $38.49 25 86817 $0.00 0.00 0.000 $71.74 25 86821 $0.00 0.00 0.000 $71.74 25 86822 $0.00 0.00 0.000 $50.52 25 86849 $0.00 0.00 0.000 $0.00 55 86850 $0.00 0.00 0.000 $16.185 86860 $0.00 0.00 0.000 $13.935 86870 $0.00 0.00 0.000 $16.175 86880 $0.00 0.00 0.000 $7.42 25 86885 $0.00 0.00 0.000 $7.90 25 86886 $0.00 0.00 0.000 $7.15 25 86900 $0.00 0.00 0.000 $4.12 25 86901 $0.00 0.00 0.000 $9.275 86903 $0.00 0.00 0.000 $13.05 25 86904 $0.00 0.00 0.000 $13.14 25 86905 $0.00 0.00 0.000 $5.28 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 22: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

22 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 86906 $0.00 0.00 0.000 $10.71 25 86920 $0.00 0.00 0.000 $13.395 86921 $0.00 0.00 0.000 $32.155 86922 $0.00 0.00 0.000 $32.405 86940 $0.00 0.00 0.000 $11.33 25 86941 $0.00 0.00 0.000 $16.73 25 86950 $0.00 0.00 0.000 $0.00 55 86999 $0.00 0.00 0.000 $0.00 55 87001 $0.00 0.00 0.000 $18.27 25 87003 $0.00 0.00 0.000 $20.06 25 87015 $0.00 0.00 0.000 $9.23 25 87040 $0.00 0.00 0.000 $14.27 25 87045 $0.00 0.00 0.000 $13.04 25 87046 $0.00 0.00 0.000 $3.26 25 87070 $0.00 0.00 0.000 $11.90 25 87071 $0.00 0.00 0.000 $6.52 25 87073 $0.00 0.00 0.000 $6.52 25 87075 $0.00 0.00 0.000 $13.08 25 87076 $0.00 0.00 0.000 $11.16 25 87077 $0.00 0.00 0.000 $11.16 25 87081 $0.00 0.00 0.000 $9.16 25 87084 $0.00 0.00 0.000 $11.90 25 87086 $0.00 0.00 0.000 $11.16 25 87088 $0.00 0.00 0.000 $11.18 25 87101 $0.00 0.00 0.000 $10.66 25 87102 $0.00 0.00 0.000 $11.61 25 87103 $0.00 0.00 0.000 $12.46 25 87106 $0.00 0.00 0.000 $14.27 25 87107 $0.00 0.00 0.000 $14.27 25 87109 $0.00 0.00 0.000 $14.40 25 87110 $0.00 0.00 0.000 $27.08 25 87116 $0.00 0.00 0.000 $14.93 25 87118 $0.00 0.00 0.000 $15.13 25 87140 $0.00 0.00 0.000 $7.71 25 87143 $0.00 0.00 0.000 $17.32 25 87147 $0.00 0.00 0.000 $7.15 25 87149 $0.00 0.00 0.000 $27.71 25 87152 $0.00 0.00 0.000 $7.23 25 87158 $0.00 0.00 0.000 $7.23 25 87164 $0.00 0.00 0.000 $14.84 25 87166 $0.00 0.00 0.000 $15.61 25 87168 $0.00 0.00 0.000 $5.90 25 87169 $0.00 0.00 0.000 $5.90 25 87172 $0.00 0.00 0.000 $5.90 25 87176 $0.00 0.00 0.000 $8.13 25 87177 $0.00 0.00 0.000 $12.09 25 87181 $0.00 0.00 0.000 $6.56 25 87184 $0.00 0.00 0.000 $9.53 25 87185 $0.00 0.00 0.000 $6.56 25 87186 $0.00 0.00 0.000 $11.94 25 87187 $0.00 0.00 0.000 $14.33 25 87188 $0.00 0.00 0.000 $9.17 25 87190 $0.00 0.00 0.000 $7.81 25 87197 $0.00 0.00 0.000 $20.76 25 87205 $0.00 0.00 0.000 $5.90 25 87206 $0.00 0.00 0.000 $7.42 25 87207 $0.00 0.00 0.000 $8.28 25 87210 $0.00 0.00 0.000 $5.90 25 87220 $0.00 0.00 0.000 $5.90 25 87230 $0.00 0.00 0.000 $27.28 25 87250 $0.00 0.00 0.000 $27.02 25 87252 $0.00 0.00 0.000 $36.02 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 23: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

23 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 87253 $0.00 0.00 0.000 $23.47 25 87254 $0.00 0.00 0.000 $6.76 25 87260 $0.00 0.00 0.000 $16.58 25 87265 $0.00 0.00 0.000 $16.58 25 87269 $0.00 0.00 0.000 $16.585 87270 $0.00 0.00 0.000 $16.58 25 87272 $0.00 0.00 0.000 $16.58 25 87273 $0.00 0.00 0.000 $16.58 25 87274 $0.00 0.00 0.000 $16.58 25 87275 $0.00 0.00 0.000 $16.58 25 87276 $0.00 0.00 0.000 $16.58 25 87277 $0.00 0.00 0.000 $16.58 25 87278 $0.00 0.00 0.000 $16.58 25 87279 $0.00 0.00 0.000 $16.58 25 87280 $0.00 0.00 0.000 $16.58 25 87281 $0.00 0.00 0.000 $16.58 25 87283 $0.00 0.00 0.000 $16.58 25 87285 $0.00 0.00 0.000 $16.58 25 87290 $0.00 0.00 0.000 $16.58 25 87299 $0.00 0.00 0.000 $16.58 25 87300 $0.00 0.00 0.000 $8.29 25 87301 $0.00 0.00 0.000 $16.58 25 87320 $0.00 0.00 0.000 $16.58 25 87324 $0.00 0.00 0.000 $16.58 25 87327 $0.00 0.00 0.000 $16.58 25 87328 $0.00 0.00 0.000 $16.58 25 87329 $0.00 0.00 0.000 $16.585 87332 $0.00 0.00 0.000 $16.58 25 87335 $0.00 0.00 0.000 $16.58 25 87336 $0.00 0.00 0.000 $16.58 25 87337 $0.00 0.00 0.000 $16.58 25 87338 $0.00 0.00 0.000 $19.88 25 87339 $0.00 0.00 0.000 $16.58 25 87340 $0.00 0.00 0.000 $14.27 25 87341 $0.00 0.00 0.000 $14.27 25 87350 $0.00 0.00 0.000 $15.92 25 87380 $0.00 0.00 0.000 $22.69 25 87385 $0.00 0.00 0.000 $16.58 25 87390 $0.00 0.00 0.000 $24.38 25 87391 $0.00 0.00 0.000 $24.38 25 87400 $0.00 0.00 0.000 $8.29 25 87420 $0.00 0.00 0.000 $16.58 25 87425 $0.00 0.00 0.000 $16.58 25 87427 $0.00 0.00 0.000 $16.58 25 87430 $0.00 0.00 0.000 $16.58 25 87449 $0.00 0.00 0.000 $16.58 25 87450 $0.00 0.00 0.000 $13.25 25 87451 $0.00 0.00 0.000 $13.25 25 87470 $0.00 0.00 0.000 $27.71 25 87471 $0.00 0.00 0.000 $48.50 25 87472 $0.00 0.00 0.000 $39.22 25 87475 $0.00 0.00 0.000 $27.71 25 87476 $0.00 0.00 0.000 $48.50 25 87477 $0.00 0.00 0.000 $39.22 25 87480 $0.00 0.00 0.000 $27.71 25 87481 $0.00 0.00 0.000 $48.50 25 87482 $0.00 0.00 0.000 $39.22 25 87485 $0.00 0.00 0.000 $27.71 25 87486 $0.00 0.00 0.000 $48.50 25 87487 $0.00 0.00 0.000 $39.22 25 87490 $0.00 0.00 0.000 $27.71 25 87491 $0.00 0.00 0.000 $48.50 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 24: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

24 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 87492 $0.00 0.00 0.000 $39.22 25 87495 $0.00 0.00 0.000 $27.71 25 87496 $0.00 0.00 0.000 $48.50 25 87497 $0.00 0.00 0.000 $39.22 25 87510 $0.00 0.00 0.000 $27.71 25 87511 $0.00 0.00 0.000 $48.50 25 87512 $0.00 0.00 0.000 $39.22 25 87515 $0.00 0.00 0.000 $27.71 25 87516 $0.00 0.00 0.000 $48.50 25 87517 $0.00 0.00 0.000 $39.22 25 87520 $0.00 0.00 0.000 $27.71 25 87521 $0.00 0.00 0.000 $48.50 25 87522 $0.00 0.00 0.000 $39.22 25 87525 $0.00 0.00 0.000 $27.71 25 87526 $0.00 0.00 0.000 $48.50 25 87527 $0.00 0.00 0.000 $39.22 25 87528 $0.00 0.00 0.000 $27.71 25 87529 $0.00 0.00 0.000 $48.50 25 87530 $0.00 0.00 0.000 $39.22 25 87531 $0.00 0.00 0.000 $27.71 25 87532 $0.00 0.00 0.000 $48.50 25 87533 $0.00 0.00 0.000 $39.22 25 87534 $0.00 0.00 0.000 $27.71 25 87535 $0.00 0.00 0.000 $48.50 25 87536 $0.00 0.00 0.000 $117.59 25 87537 $0.00 0.00 0.000 $27.71 25 87538 $0.00 0.00 0.000 $48.50 25 87539 $0.00 0.00 0.000 $39.22 25 87540 $0.00 0.00 0.000 $27.71 25 87541 $0.00 0.00 0.000 $48.50 25 87542 $0.00 0.00 0.000 $39.22 25 87550 $0.00 0.00 0.000 $27.71 25 87551 $0.00 0.00 0.000 $48.50 25 87552 $0.00 0.00 0.000 $39.22 25 87555 $0.00 0.00 0.000 $27.71 25 87556 $0.00 0.00 0.000 $48.50 25 87557 $0.00 0.00 0.000 $39.22 25 87560 $0.00 0.00 0.000 $27.71 25 87561 $0.00 0.00 0.000 $48.50 25 87562 $0.00 0.00 0.000 $39.22 25 87580 $0.00 0.00 0.000 $27.71 25 87581 $0.00 0.00 0.000 $48.50 25 87582 $0.00 0.00 0.000 $39.22 25 87590 $0.00 0.00 0.000 $27.71 25 87591 $0.00 0.00 0.000 $48.50 25 87592 $0.00 0.00 0.000 $39.22 25 87620 $0.00 0.00 0.000 $27.71 25 87621 $0.00 0.00 0.000 $48.50 25 87622 $0.00 0.00 0.000 $39.22 25 87650 $0.00 0.00 0.000 $27.71 25 87651 $0.00 0.00 0.000 $48.50 25 87652 $0.00 0.00 0.000 $39.22 25 87660 $0.00 0.00 0.000 $27.715 87797 $0.00 0.00 0.000 $27.71 25 87798 $0.00 0.00 0.000 $48.50 25 87799 $0.00 0.00 0.000 $59.20 25 87800 $0.00 0.00 0.000 $27.71 25 87801 $0.00 0.00 0.000 $48.50 25 87802 $0.00 0.00 0.000 $16.58 25 87803 $0.00 0.00 0.000 $16.58 25 87804 $0.00 0.00 0.000 $16.58 25 87807 $0.00 0.00 0.000 $16.58 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 25: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

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TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

25 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 87810 $0.00 0.00 0.000 $16.58 25 87850 $0.00 0.00 0.000 $16.58 25 87880 $0.00 0.00 0.000 $16.58 25 87899 $0.00 0.00 0.000 $16.58 25 87902 $0.00 0.00 0.000 $253.26 25 87999 $0.00 0.00 0.000 $0.00 55 88104 $24.82 0.91 27.276 $0.005 88106 $23.18 0.85 27.276 $0.005 88107 $32.73 1.20 27.276 $0.005 88108 $25.37 0.93 27.276 $0.005 88112 $88.37 3.24 27.276 $0.00I 88112 26 $47.73 1.75 27.276 $0.00T 88112 TC $40.64 1.49 27.276 $0.005 88142 $0.00 0.00 0.000 $25.00 25 88143 $0.00 0.00 0.000 $25.00 25 88147 $0.00 0.00 0.000 $15.73 25 88148 $0.00 0.00 0.000 $21.00 25 88150 $0.00 0.00 0.000 $14.60 25 88152 $0.00 0.00 0.000 $14.60 25 88153 $0.00 0.00 0.000 $14.60 25 88154 $0.00 0.00 0.000 $14.60 25 88155 $0.00 0.00 0.000 $8.28 25 88160 $21.82 0.80 27.276 $0.005 88161 $23.46 0.86 27.276 $0.005 88162 $40.10 1.47 27.276 $0.005 88164 $0.00 0.00 0.000 $14.60 25 88165 $0.00 0.00 0.000 $14.60 25 88166 $0.00 0.00 0.000 $14.60 25 88167 $0.00 0.00 0.000 $14.60 25 88172 $33.55 1.23 27.276 $0.005 88173 $49.10 1.80 27.276 $0.005 88182 $42.55 1.56 27.276 $0.005 88199 $0.00 0.00 0.000 $0.00 55 88300 $7.09 0.26 27.276 $0.005 88302 $15.00 0.55 27.276 $0.005 88304 $21.55 0.79 27.276 $0.005 88305 $46.10 1.69 27.276 $0.005 88307 $81.28 2.98 27.276 $0.005 88309 $110.20 4.04 27.276 $0.005 88311 $11.46 0.42 27.276 $0.005 88312 $13.91 0.51 27.276 $0.005 88313 $11.46 0.42 27.276 $0.005 88314 $31.64 1.16 27.276 $0.005 88318 $13.09 0.48 27.276 $0.005 88319 $27.00 0.99 27.276 $0.005 88342 $19.64 0.72 27.276 $0.005 88346 $18.55 0.68 27.276 $0.005 88347 $13.91 0.51 27.276 $0.005 88348 $96.28 3.53 27.276 $0.005 88349 $57.83 2.12 27.276 $0.005 88355 $93.83 3.44 27.276 $0.005 88356 $148.93 5.46 27.276 $0.005 88358 $134.20 4.92 27.276 $0.005 88360 $79.37 2.91 27.276 $0.005 88361 $101.47 3.72 27.276 $0.00I 88361 26 $40.10 1.47 27.276 $0.00T 88361 TC $61.37 2.25 27.276 $0.005 88362 $107.47 3.94 27.276 $0.005 88367 $93.83 3.44 27.276 $0.005 88368 $93.83 3.44 27.276 $0.005 88371 $0.00 0.00 0.000 $30.71 25 88372 $0.00 0.00 0.000 $31.44 2

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

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TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

26 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

5 88399 $0.00 0.00 0.000 $0.00 55 88400 $0.00 0.00 0.000 $3.47 25 89050 $0.00 0.00 0.000 $6.53 25 89051 $0.00 0.00 0.000 $7.61 25 89060 $0.00 0.00 0.000 $9.88 25 89100 $30.28 1.11 27.276 $0.005 89105 $26.73 0.98 27.276 $0.005 89125 $0.00 0.00 0.000 $5.96 25 89130 $25.37 0.93 27.276 $0.005 89132 $11.46 0.42 27.276 $0.005 89135 $40.64 1.49 27.276 $0.005 89136 $12.82 0.47 27.276 $0.005 89140 $52.10 1.91 27.276 $0.005 89141 $47.19 1.73 27.276 $0.005 89160 $0.00 0.00 0.000 $5.09 25 89190 $0.00 0.00 0.000 $6.56 25 89220 $10.91 0.40 27.276 $0.005 89225 $0.00 0.00 0.000 $4.625 89230 $0.00 0.00 0.000 $12.005 89235 $0.00 0.00 0.000 $5.125 89240 $0.00 0.00 0.000 $0.00 5I 89240 26 $0.00 0.00 0.000 $0.00 51 90703 $0.00 0.00 0.000 $3.211 90760 $45.55 1.67 27.276 $0.001 90761 $14.46 0.53 27.276 $0.001 90765 $55.64 2.04 27.276 $0.001 90766 $18.55 0.68 27.276 $0.001 90767 $30.55 1.12 27.276 $0.001 90768 $17.73 0.65 27.276 $0.001 90772 $13.37 0.49 27.276 $0.001 90773 $0.00 0.00 0.000 $12.001 90774 $41.46 1.52 27.276 $0.001 90775 $19.37 0.71 27.276 $0.001 90779 $0.00 0.00 0.000 $0.005 93701 $26.46 0.97 27.276 $0.004 93922 $50.46 1.85 27.276 $0.00I 93922 26 $16.37 0.60 27.276 $0.00T 93922 TC $34.10 1.25 27.276 $0.004 93925 $138.29 5.07 27.276 $0.00I 93925 26 $31.91 1.17 27.276 $0.00T 93925 TC $106.38 3.90 27.276 $0.004 93926 $90.83 3.33 27.276 $0.00I 93926 26 $18.55 0.68 27.276 $0.00T 93926 TC $72.28 2.65 27.276 $0.004 93965 $58.37 2.14 27.276 $0.00I 93965 26 $25.09 0.92 27.276 $0.00T 93965 TC $33.28 1.22 27.276 $0.004 93970 $144.02 5.28 27.276 $0.00I 93970 26 $37.64 1.38 27.276 $0.00T 93970 TC $106.38 3.90 27.276 $0.004 93971 $100.38 3.68 27.276 $0.00I 93971 26 $20.46 0.75 27.276 $0.00T 93971 TC $79.92 2.93 27.276 $0.005 95851 $15.27 0.56 27.276 $0.005 95870 $25.91 0.95 27.276 $0.001 95873 $21.00 0.77 27.276 $0.001 95874 $21.28 0.78 27.276 $0.005 95900 $30.82 1.13 27.276 $0.00I 95900 26 $22.64 0.83 27.276 $0.005 95903 $33.82 1.24 27.276 $0.00I 95903 26 $26.73 0.98 27.276 $0.005 95904 $26.46 0.97 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

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DATE: 05/02/2006PROGRAM: MEDICAID

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TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

27 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

I 95904 26 $19.91 0.73 27.276 $0.005 95934 $30.00 1.10 27.276 $0.00I 95934 26 $24.00 0.88 27.276 $0.005 95936 $31.09 1.14 27.276 $0.00I 95936 26 $25.09 0.92 27.276 $0.001 96570 $57.01 2.09 27.276 $0.001 96571 $31.09 1.14 27.276 $0.001 97001 $0.00 0.00 0.000 $140.001 97002 $0.00 0.00 0.000 $140.001 97003 $0.00 0.00 0.000 $140.001 97004 $0.00 0.00 0.000 $140.001 97012 $0.00 0.00 0.000 $35.001 97014 $0.00 0.00 0.000 $35.001 97016 $0.00 0.00 0.000 $35.001 97018 $0.00 0.00 0.000 $35.001 97022 $0.00 0.00 0.000 $35.001 97024 $0.00 0.00 0.000 $35.001 97026 $0.00 0.00 0.000 $35.001 97028 $0.00 0.00 0.000 $35.001 97032 $0.00 0.00 0.000 $35.001 97033 $0.00 0.00 0.000 $35.001 97034 $0.00 0.00 0.000 $35.001 97035 $0.00 0.00 0.000 $35.001 97036 $0.00 0.00 0.000 $35.001 97039 $0.00 0.00 0.000 $35.001 97110 $0.00 0.00 0.000 $35.001 97112 $0.00 0.00 0.000 $35.001 97113 $0.00 0.00 0.000 $35.001 97116 $0.00 0.00 0.000 $35.001 97124 $0.00 0.00 0.000 $35.001 97139 $0.00 0.00 0.000 $35.001 97140 $0.00 0.00 0.000 $35.001 97150 $0.00 0.00 0.000 $17.501 97530 $0.00 0.00 0.000 $35.001 97750 $0.00 0.00 0.000 $35.001 97761 $0.00 0.00 0.000 $35.001 97799 $0.00 0.00 0.000 $35.00 51 98925 $19.64 0.72 27.276 $0.001 98926 $29.73 1.09 27.276 $0.001 98927 $35.19 1.29 27.276 $0.001 98928 $40.91 1.50 27.276 $0.001 98929 $44.19 1.62 27.276 $0.001 99000 $0.00 0.00 0.000 $3.551 99050 $0.00 0.00 0.000 $12.691 99056 $0.00 0.00 0.000 $12.691 99058 $0.00 0.00 0.000 $15.731 99060 $0.00 0.00 0.000 $12.691 99199 $0.00 0.00 0.000 $0.00 51 99201 $22.64 0.83 27.276 $0.00 1, 112 99201 $22.64 0.83 27.276 $0.00 1,111 99202 $35.73 1.31 27.276 $0.00 1, 112 99202 $35.73 1.31 27.276 $0.00 1,111 99203 $48.28 1.77 27.276 $0.00 1,112 99203 $48.28 1.77 27.276 $0.00 1,111 99204 $70.64 2.59 27.276 $0.00 1, 112 99204 $70.64 2.59 27.276 $0.00 1,111 99205 $87.83 3.22 27.276 $0.00 1,112 99205 $87.83 3.22 27.276 $0.00 1, 111 99211 $11.73 0.43 27.276 $0.00 1, 111 99212 $19.64 0.72 27.276 $0.00 1, 111 99213 $0.00 0.00 0.000 $29.52 1,111 99214 $41.46 1.52 27.276 $0.00 1,11

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

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DATE: 05/02/2006PROGRAM: MEDICAID

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TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

28 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

1 99215 $63.83 2.34 27.276 $0.00 1, 111 99217 $0.00 0.00 0.000 $45.551 99218 $0.00 0.00 0.000 $45.681 99219 $0.00 0.00 0.000 $71.051 99220 $0.00 0.00 0.000 $96.431 99221 $52.10 1.91 27.276 $0.001 99222 $82.65 3.03 27.276 $0.001 99223 $104.47 3.83 27.276 $0.001 99231 $27.55 1.01 27.276 $0.001 99232 $39.55 1.45 27.276 $0.001 99233 $53.19 1.95 27.276 $0.001 99234 $90.01 3.30 27.276 $0.001 99235 $124.38 4.56 27.276 $0.001 99236 $150.02 5.50 27.276 $0.001 99238 $47.46 1.74 27.276 $0.001 99239 $0.00 0.00 0.000 $62.743 99241 $35.19 1.29 27.276 $0.003 99242 $55.10 2.02 27.276 $0.003 99243 $71.19 2.61 27.276 $0.003 99244 $99.83 3.66 27.276 $0.003 99245 $132.56 4.86 27.276 $0.003 99251 $37.91 1.39 27.276 $0.003 99252 $56.46 2.07 27.276 $0.003 99253 $72.83 2.67 27.276 $0.003 99254 $100.65 3.69 27.276 $0.003 99255 $132.02 4.84 27.276 $0.001 99281 $0.00 0.00 0.000 $22.63 11 99282 $0.00 0.00 0.000 $35.73 11 99283 $0.00 0.00 0.000 $48.28 11 99284 $0.00 0.00 0.000 $70.64 11 99285 $0.00 0.00 0.000 $87.83 11 99304 $39.00 1.43 27.276 $0.001 99305 $46.64 1.71 27.276 $0.001 99306 $63.28 2.32 27.276 $0.001 99307 $24.28 0.89 27.276 $0.001 99308 $32.19 1.18 27.276 $0.001 99309 $43.64 1.60 27.276 $0.001 99310 $43.64 1.60 27.276 $0.001 99315 $45.82 1.68 27.276 $0.001 99316 $55.92 2.05 27.276 $0.001 99318 $39.00 1.43 27.276 $0.001 99324 $31.64 1.16 27.276 $0.001 99325 $45.55 1.67 27.276 $0.001 99326 $60.01 2.20 27.276 $0.001 99327 $60.01 2.20 27.276 $0.001 99328 $60.01 2.20 27.276 $0.001 99334 $32.73 1.20 27.276 $0.001 99335 $49.92 1.83 27.276 $0.001 99336 $73.10 2.68 27.276 $0.001 99337 $73.10 2.68 27.276 $0.001 99341 $43.10 1.58 27.276 $0.002 99341 $43.10 1.58 27.276 $0.001 99342 $54.55 2.00 27.276 $0.002 99342 $54.55 2.00 27.276 $0.001 99343 $70.64 2.59 27.276 $0.002 99343 $70.64 2.59 27.276 $0.001 99344 $108.29 3.97 27.276 $0.002 99344 $108.29 3.97 27.276 $0.001 99345 $129.02 4.73 27.276 $0.002 99345 $129.02 4.73 27.276 $0.001 99347 $34.10 1.25 27.276 $0.001 99348 $49.92 1.83 27.276 $0.00

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

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DATE: 05/02/2006PROGRAM: MEDICAID

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TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

29 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

1 99349 $73.10 2.68 27.276 $0.001 99350 $105.29 3.86 27.276 $0.001 99499 $0.00 0.00 0.000 $0.00 53 99499 $0.00 0.00 0.000 $0.00 59 A4450 $0.00 0.00 0.000 $0.09 71 C9220 $0.00 0.00 0.000 $186.161 C9399 $0.00 0.00 0.000 $0.005 G0103 $0.00 0.00 0.000 $25.42 25 G0107 $0.00 0.00 0.000 $3.50 22 G0127 $11.73 0.43 27.276 $0.005 G0306 $0.00 0.00 0.000 $10.745 G0307 $0.00 0.00 0.000 $8.951 J0120 $0.00 0.00 0.000 $14.971 J0132 $0.00 0.00 0.000 $1.921 J0133 $0.00 0.00 0.000 $0.201 J0150 $0.00 0.00 0.000 $31.331 J0170 $0.00 0.00 0.000 $0.691 J0190 $0.00 0.00 0.000 $2.981 J0205 $0.00 0.00 0.000 $35.361 J0207 $0.00 0.00 0.000 $434.061 J0210 $0.00 0.00 0.000 $9.061 J0215 $0.00 0.00 0.000 $25.501 J0256 $0.00 0.00 0.000 $1.971 J0278 $0.00 0.00 0.000 $1.331 J0280 $0.00 0.00 0.000 $0.981 J0285 $0.00 0.00 0.000 $15.961 J0290 $0.00 0.00 0.000 $0.931 J0295 $0.00 0.00 0.000 $6.871 J0300 $0.00 0.00 0.000 $2.071 J0330 $0.00 0.00 0.000 $0.091 J0350 $0.00 0.00 0.000 $2,537.841 J0360 $0.00 0.00 0.000 $7.831 J0380 $0.00 0.00 0.000 $1.151 J0390 $0.00 0.00 0.000 $15.871 J0456 $0.00 0.00 0.000 $21.941 J0460 $0.00 0.00 0.000 $0.461 J0470 $0.00 0.00 0.000 $22.301 J0475 $0.00 0.00 0.000 $209.431 J0476 $0.00 0.00 0.000 $70.021 J0480 $0.00 0.00 0.000 $1,445.311 J0500 $0.00 0.00 0.000 $1.711 J0515 $0.00 0.00 0.000 $3.371 J0520 $0.00 0.00 0.000 $5.031 J0530 $0.00 0.00 0.000 $3.911 J0540 $0.00 0.00 0.000 $13.561 J0550 $0.00 0.00 0.000 $29.041 J0560 $0.00 0.00 0.000 $8.651 J0570 $0.00 0.00 0.000 $10.681 J0580 $0.00 0.00 0.000 $30.901 J0583 $0.00 0.00 0.000 $1.561 J0585 $0.00 0.00 0.000 $4.661 J0595 $0.00 0.00 0.000 $3.431 J0600 $0.00 0.00 0.000 $37.771 J0610 $0.00 0.00 0.000 $1.231 J0620 $0.00 0.00 0.000 $3.441 J0640 $0.00 0.00 0.000 $16.501 J0670 $0.00 0.00 0.000 $2.201 J0690 $0.00 0.00 0.000 $2.551 J0694 $0.00 0.00 0.000 $9.981 J0696 $0.00 0.00 0.000 $12.581 J0697 $0.00 0.00 0.000 $8.381 J0698 $0.00 0.00 0.000 $12.88

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

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DATE: 05/02/2006PROGRAM: MEDICAID

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30 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

1 J0702 $0.00 0.00 0.000 $4.501 J0704 $0.00 0.00 0.000 $2.451 J0710 $0.00 0.00 0.000 $1.471 J0713 $0.00 0.00 0.000 $6.361 J0715 $0.00 0.00 0.000 $5.791 J0720 $0.00 0.00 0.000 $5.741 J0725 $0.00 0.00 0.000 $3.271 J0735 $0.00 0.00 0.000 $50.371 J0740 $0.00 0.00 0.000 $757.171 J0743 $0.00 0.00 0.000 $14.411 J0745 $0.00 0.00 0.000 $1.061 J0760 $0.00 0.00 0.000 $4.511 J0770 $0.00 0.00 0.000 $37.711 J0780 $0.00 0.00 0.000 $2.791 J0800 $0.00 0.00 0.000 $87.551 J0835 $0.00 0.00 0.000 $14.501 J0850 $0.00 0.00 0.000 $349.051 J0881 $0.00 0.00 0.000 $4.241 J0885 $0.00 0.00 0.000 $11.441 J0895 $0.00 0.00 0.000 $11.331 J0900 $0.00 0.00 0.000 $3.571 J0945 $0.00 0.00 0.000 $0.731 J0970 $0.00 0.00 0.000 $1.711 J1000 $0.00 0.00 0.000 $0.811 J1020 $0.00 0.00 0.000 $2.231 J1030 $0.00 0.00 0.000 $1.501 J1040 $0.00 0.00 0.000 $2.681 J1060 $0.00 0.00 0.000 $3.571 J1070 $0.00 0.00 0.000 $1.201 J1080 $0.00 0.00 0.000 $1.931 J1094 $0.00 0.00 0.000 $0.261 J1100 $0.00 0.00 0.000 $0.911 J1110 $0.00 0.00 0.000 $13.741 J1120 $0.00 0.00 0.000 $35.691 J1160 $0.00 0.00 0.000 $1.691 J1162 $0.00 0.00 0.000 $510.001 J1165 $0.00 0.00 0.000 $0.651 J1170 $0.00 0.00 0.000 $1.091 J1180 $0.00 0.00 0.000 $7.441 J1190 $0.00 0.00 0.000 $183.271 J1200 $0.00 0.00 0.000 $0.191 J1205 $0.00 0.00 0.000 $9.241 J1230 $0.00 0.00 0.000 $0.711 J1240 $0.00 0.00 0.000 $0.631 J1245 $0.00 0.00 0.000 $20.611 J1250 $0.00 0.00 0.000 $8.721 J1260 $0.00 0.00 0.000 $15.501 J1265 $0.00 0.00 0.000 $0.581 J1320 $0.00 0.00 0.000 $2.011 J1325 $0.00 0.00 0.000 $15.571 J1327 $0.00 0.00 0.000 $10.401 J1330 $0.00 0.00 0.000 $4.241 J1335 $0.00 0.00 0.000 $21.001 J1364 $0.00 0.00 0.000 $5.601 J1380 $0.00 0.00 0.000 $0.591 J1390 $0.00 0.00 0.000 $1.171 J1410 $0.00 0.00 0.000 $51.911 J1430 $0.00 0.00 0.000 $70.981 J1435 $0.00 0.00 0.000 $0.171 J1436 $0.00 0.00 0.000 $59.971 J1438 $0.00 0.00 0.000 $126.641 J1450 $0.00 0.00 0.000 $81.52

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

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31 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

1 J1451 $0.00 0.00 0.000 $11.291 J1455 $0.00 0.00 0.000 $11.471 J1460 $0.00 0.00 0.000 $1.501 J1470 $0.00 0.00 0.000 $3.011 J1480 $0.00 0.00 0.000 $4.521 J1490 $0.00 0.00 0.000 $6.031 J1500 $0.00 0.00 0.000 $7.541 J1510 $0.00 0.00 0.000 $9.041 J1520 $0.00 0.00 0.000 $10.551 J1530 $0.00 0.00 0.000 $12.061 J1540 $0.00 0.00 0.000 $13.571 J1550 $0.00 0.00 0.000 $15.071 J1560 $0.00 0.00 0.000 $0.00 51 J1566 $0.00 0.00 0.000 $35.071 J1567 $0.00 0.00 0.000 $41.311 J1570 $0.00 0.00 0.000 $31.931 J1580 $0.00 0.00 0.000 $2.311 J1600 $0.00 0.00 0.000 $12.731 J1610 $0.00 0.00 0.000 $42.961 J1620 $0.00 0.00 0.000 $181.231 J1626 $0.00 0.00 0.000 $17.471 J1630 $0.00 0.00 0.000 $6.711 J1631 $0.00 0.00 0.000 $20.851 J1642 $0.00 0.00 0.000 $0.131 J1644 $0.00 0.00 0.000 $0.741 J1645 $0.00 0.00 0.000 $13.741 J1650 $0.00 0.00 0.000 $5.771 J1652 $0.00 0.00 0.000 $7.401 J1670 $0.00 0.00 0.000 $96.661 J1700 $0.00 0.00 0.000 $0.321 J1710 $0.00 0.00 0.000 $5.001 J1720 $0.00 0.00 0.000 $2.091 J1730 $0.00 0.00 0.000 $106.311 J1742 $0.00 0.00 0.000 $208.001 J1745 $0.00 0.00 0.000 $59.571 J1751 $0.00 0.00 0.000 $16.021 J1752 $0.00 0.00 0.000 $16.021 J1785 $0.00 0.00 0.000 $3.531 J1790 $0.00 0.00 0.000 $3.081 J1800 $0.00 0.00 0.000 $10.951 J1810 $0.00 0.00 0.000 $8.891 J1825 $0.00 0.00 0.000 $212.171 J1840 $0.00 0.00 0.000 $3.741 J1850 $0.00 0.00 0.000 $2.851 J1885 $0.00 0.00 0.000 $3.351 J1890 $0.00 0.00 0.000 $9.701 J1940 $0.00 0.00 0.000 $0.831 J1945 $0.00 0.00 0.000 $147.291 J1950 $0.00 0.00 0.000 $394.361 J1956 $0.00 0.00 0.000 $17.721 J1960 $0.00 0.00 0.000 $4.061 J1980 $0.00 0.00 0.000 $6.621 J1990 $0.00 0.00 0.000 $23.541 J2010 $0.00 0.00 0.000 $1.361 J2060 $0.00 0.00 0.000 $9.131 J2150 $0.00 0.00 0.000 $2.031 J2175 $0.00 0.00 0.000 $0.981 J2180 $0.00 0.00 0.000 $4.081 J2185 $0.00 0.00 0.000 $4.671 J2210 $0.00 0.00 0.000 $3.341 J2260 $0.00 0.00 0.000 $38.591 J2270 $0.00 0.00 0.000 $1.04

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 32: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

32 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

1 J2271 $0.00 0.00 0.000 $18.501 J2275 $0.00 0.00 0.000 $10.571 J2300 $0.00 0.00 0.000 $1.221 J2310 $0.00 0.00 0.000 $3.051 J2320 $0.00 0.00 0.000 $4.901 J2321 $0.00 0.00 0.000 $6.751 J2322 $0.00 0.00 0.000 $24.331 J2325 $0.00 0.00 0.000 $30.031 J2355 $0.00 0.00 0.000 $222.631 J2360 $0.00 0.00 0.000 $2.321 J2370 $0.00 0.00 0.000 $2.751 J2400 $0.00 0.00 0.000 $8.931 J2405 $0.00 0.00 0.000 $5.741 J2410 $0.00 0.00 0.000 $2.641 J2425 $0.00 0.00 0.000 $11.221 J2430 $0.00 0.00 0.000 $239.281 J2440 $0.00 0.00 0.000 $4.801 J2460 $0.00 0.00 0.000 $0.871 J2501 $0.00 0.00 0.000 $4.491 J2510 $0.00 0.00 0.000 $5.891 J2513 $0.00 0.00 0.000 $12.981 J2515 $0.00 0.00 0.000 $0.641 J2540 $0.00 0.00 0.000 $1.281 J2543 $0.00 0.00 0.000 $4.911 J2550 $0.00 0.00 0.000 $0.761 J2560 $0.00 0.00 0.000 $4.371 J2590 $0.00 0.00 0.000 $0.921 J2597 $0.00 0.00 0.000 $5.391 J2650 $0.00 0.00 0.000 $0.321 J2670 $0.00 0.00 0.000 $3.521 J2680 $0.00 0.00 0.000 $12.941 J2690 $0.00 0.00 0.000 $10.391 J2700 $0.00 0.00 0.000 $0.791 J2710 $0.00 0.00 0.000 $0.601 J2720 $0.00 0.00 0.000 $0.531 J2730 $0.00 0.00 0.000 $74.611 J2760 $0.00 0.00 0.000 $30.691 J2765 $0.00 0.00 0.000 $0.891 J2770 $0.00 0.00 0.000 $96.131 J2780 $0.00 0.00 0.000 $1.351 J2788 $0.00 0.00 0.000 $32.141 J2790 $0.00 0.00 0.000 $126.141 J2792 $0.00 0.00 0.000 $20.591 J2795 $0.00 0.00 0.000 $0.141 J2800 $0.00 0.00 0.000 $3.581 J2810 $0.00 0.00 0.000 $0.901 J2910 $0.00 0.00 0.000 $14.281 J2912 $0.00 0.00 0.000 $0.741 J2920 $0.00 0.00 0.000 $1.561 J2930 $0.00 0.00 0.000 $1.791 J2950 $0.00 0.00 0.000 $0.421 J2993 $0.00 0.00 0.000 $1,230.631 J2995 $0.00 0.00 0.000 $113.771 J2997 $0.00 0.00 0.000 $24.611 J3000 $0.00 0.00 0.000 $6.281 J3010 $0.00 0.00 0.000 $1.161 J3030 $0.00 0.00 0.000 $26.741 J3070 $0.00 0.00 0.000 $1.331 J3105 $0.00 0.00 0.000 $2.001 J3120 $0.00 0.00 0.000 $0.571 J3130 $0.00 0.00 0.000 $1.071 J3140 $0.00 0.00 0.000 $0.75

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 33: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

33 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

1 J3150 $0.00 0.00 0.000 $0.891 J3230 $0.00 0.00 0.000 $2.151 J3240 $0.00 0.00 0.000 $465.401 J3250 $0.00 0.00 0.000 $1.671 J3260 $0.00 0.00 0.000 $6.951 J3265 $0.00 0.00 0.000 $2.071 J3280 $0.00 0.00 0.000 $4.581 J3285 $0.00 0.00 0.000 $58.181 J3301 $0.00 0.00 0.000 $1.501 J3302 $0.00 0.00 0.000 $0.811 J3303 $0.00 0.00 0.000 $2.381 J3305 $0.00 0.00 0.000 $73.841 J3310 $0.00 0.00 0.000 $6.171 J3315 $0.00 0.00 0.000 $371.641 J3320 $0.00 0.00 0.000 $25.251 J3350 $0.00 0.00 0.000 $0.851 J3360 $0.00 0.00 0.000 $2.361 J3364 $0.00 0.00 0.000 $53.331 J3365 $0.00 0.00 0.000 $439.171 J3370 $0.00 0.00 0.000 $12.311 J3400 $0.00 0.00 0.000 $11.161 J3410 $0.00 0.00 0.000 $0.791 J3411 $0.00 0.00 0.000 $0.811 J3420 $0.00 0.00 0.000 $0.221 J3430 $0.00 0.00 0.000 $2.461 J3470 $0.00 0.00 0.000 $19.391 J3471 $0.00 0.00 0.000 $0.131 J3472 $0.00 0.00 0.000 $130.001 J3475 $0.00 0.00 0.000 $3.451 J3480 $0.00 0.00 0.000 $0.091 J3485 $0.00 0.00 0.000 $0.901 J3487 $0.00 0.00 0.000 $194.601 J3490 $0.00 0.00 0.000 $0.001 J3520 $0.00 0.00 0.000 $3.151 J7188 $0.00 0.00 0.000 $0.851 J7189 $0.00 0.00 0.000 $1.261 J7190 $0.00 0.00 0.000 $0.901 J7191 $0.00 0.00 0.000 $1.671 J7192 $0.00 0.00 0.000 $0.921 J7194 $0.00 0.00 0.000 $0.401 J7197 $0.00 0.00 0.000 $0.981 J7198 $0.00 0.00 0.000 $1.351 J7199 $0.00 0.00 0.000 $0.00 51 J7317 $0.00 0.00 0.000 $127.331 J7320 $0.00 0.00 0.000 $201.491 J7340 $0.00 0.00 0.000 $26.321 J7341 $0.00 0.00 0.000 $26.321 J7342 $0.00 0.00 0.000 $14.421 J7501 $0.00 0.00 0.000 $53.541 J7504 $0.00 0.00 0.000 $253.471 J7505 $0.00 0.00 0.000 $698.101 J7513 $0.00 0.00 0.000 $374.291 J7516 $0.00 0.00 0.000 $26.101 J7525 $0.00 0.00 0.000 $106.591 J7599 $0.00 0.00 0.000 $0.00 51 J7611 $0.00 0.00 0.000 $0.131 J7612 $0.00 0.00 0.000 $0.131 J7613 $0.00 0.00 0.000 $0.181 J7614 $0.00 0.00 0.000 $0.181 J7620 $0.00 0.00 0.000 $0.801 J7699 $0.00 0.00 0.000 $0.00 51 J7799 $0.00 0.00 0.000 $0.00 5

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 34: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

34 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

1 J9000 $0.00 0.00 0.000 $48.011 J9010 $0.00 0.00 0.000 $457.541 J9015 $0.00 0.00 0.000 $604.131 J9020 $0.00 0.00 0.000 $56.241 J9025 $0.00 0.00 0.000 $4.051 J9040 $0.00 0.00 0.000 $272.621 J9045 $0.00 0.00 0.000 $104.681 J9050 $0.00 0.00 0.000 $121.831 J9060 $0.00 0.00 0.000 $39.861 J9062 $0.00 0.00 0.000 $199.301 J9065 $0.00 0.00 0.000 $50.361 J9070 $0.00 0.00 0.000 $5.771 J9080 $0.00 0.00 0.000 $10.961 J9090 $0.00 0.00 0.000 $23.011 J9091 $0.00 0.00 0.000 $46.021 J9092 $0.00 0.00 0.000 $92.081 J9093 $0.00 0.00 0.000 $5.771 J9094 $0.00 0.00 0.000 $10.961 J9095 $0.00 0.00 0.000 $23.011 J9096 $0.00 0.00 0.000 $46.021 J9097 $0.00 0.00 0.000 $92.081 J9100 $0.00 0.00 0.000 $6.061 J9110 $0.00 0.00 0.000 $22.381 J9120 $0.00 0.00 0.000 $12.461 J9130 $0.00 0.00 0.000 $9.941 J9140 $0.00 0.00 0.000 $24.821 J9150 $0.00 0.00 0.000 $70.561 J9151 $0.00 0.00 0.000 $60.861 J9165 $0.00 0.00 0.000 $13.581 J9170 $0.00 0.00 0.000 $294.621 J9181 $0.00 0.00 0.000 $9.851 J9182 $0.00 0.00 0.000 $98.451 J9185 $0.00 0.00 0.000 $268.891 J9190 $0.00 0.00 0.000 $2.541 J9200 $0.00 0.00 0.000 $122.061 J9201 $0.00 0.00 0.000 $100.541 J9202 $0.00 0.00 0.000 $420.641 J9206 $0.00 0.00 0.000 $118.211 J9208 $0.00 0.00 0.000 $147.571 J9209 $0.00 0.00 0.000 $34.371 J9211 $0.00 0.00 0.000 $337.691 J9212 $0.00 0.00 0.000 $3.851 J9213 $0.00 0.00 0.000 $32.861 J9214 $0.00 0.00 0.000 $12.711 J9215 $0.00 0.00 0.000 $7.401 J9216 $0.00 0.00 0.000 $179.891 J9217 $0.00 0.00 0.000 $558.291 J9218 $0.00 0.00 0.000 $19.791 J9225 $0.00 0.00 0.000 $5,100.001 J9230 $0.00 0.00 0.000 $10.791 J9245 $0.00 0.00 0.000 $359.551 J9250 $0.00 0.00 0.000 $0.411 J9260 $0.00 0.00 0.000 $3.351 J9264 $0.00 0.00 0.000 $8.461 J9266 $0.00 0.00 0.000 $1,245.131 J9268 $0.00 0.00 0.000 $1,558.371 J9270 $0.00 0.00 0.000 $88.371 J9280 $0.00 0.00 0.000 $114.611 J9290 $0.00 0.00 0.000 $389.321 J9291 $0.00 0.00 0.000 $802.651 J9293 $0.00 0.00 0.000 $230.051 J9310 $0.00 0.00 0.000 $428.22

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies

Page 35: Texas Medicaid Fee Schedule Information Podiatrist May 2006 Schedules/2006/Texas... · 2008-06-18 · Podiatrist May 2006 The Texas Medicaid & Healthcare Partnership (TMHP) ... Austin,

DATE: 05/02/2006PROGRAM: MEDICAID

Due to AMA and ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published.

TEXAS MEDICAID FEE SCHEDULE - PODIATRIST

35 of 35

TOS Procedure Modifier TMRM Total Conv Access Based NoteCode Payable RVUs Factor or Max Fee Code

1 J9320 $0.00 0.00 0.000 $110.831 J9340 $0.00 0.00 0.000 $110.191 J9350 $0.00 0.00 0.000 $595.931 J9355 $0.00 0.00 0.000 $52.381 J9357 $0.00 0.00 0.000 $398.721 J9360 $0.00 0.00 0.000 $2.961 J9370 $0.00 0.00 0.000 $32.011 J9375 $0.00 0.00 0.000 $60.051 J9380 $0.00 0.00 0.000 $145.631 J9390 $0.00 0.00 0.000 $85.471 J9600 $0.00 0.00 0.000 $2,460.471 J9999 $0.00 0.00 0.000 $0.00 59 L8623 $0.00 0.00 0.000 $52.455 P2038 $0.00 0.00 0.000 $6.95 25 P7001 $0.00 0.00 0.000 $16.67 25 P9012 $0.00 0.00 0.000 $7.365 Q0095 $0.00 0.00 0.000 $1.20 25 Q0100 $0.00 0.00 0.000 $2.33 25 Q0111 $0.00 0.00 0.000 $5.90 25 Q0112 $0.00 0.00 0.000 $5.90 25 Q0113 $0.00 0.00 0.000 $7.47 25 Q0115 $0.00 0.00 0.000 $13.68 21 Q2009 $0.00 0.00 0.000 $8.061 Q3025 $0.00 0.00 0.000 $70.721 Q3026 $0.00 0.00 0.000 $70.721 S0020 $0.00 0.00 0.000 $6.361 S0021 $0.00 0.00 0.000 $15.131 S0023 $0.00 0.00 0.000 $3.021 S0142 $0.00 0.00 0.000 $0.171 S0162 $0.00 0.00 0.000 $291.551 S0167 $0.00 0.00 0.000 $0.359 S0515 $0.00 0.00 0.000 $0.00 52 S2117 $591.34 21.68 27.276 $0.002 S2135 $231.30 8.48 27.276 $0.005 S3625 $0.00 0.00 0.000 $68.685 S3626 $0.00 0.00 0.000 $94.371 S4993 $0.00 0.00 0.000 $2.801 S8990 $0.00 0.00 0.000 $7.37

Medicaid payments for services by professional and outpatient facilities under fee-for-service and PCCM programs covered by this feeschedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs and biologicals, and DME and supplies