Foster Care Article 29-I Other Limited Health Services Schedule Summary

May 21

  • Schedule also available in Portable Document Format (PDF)
Service Description Rate Code Unit Upstate Downstate Statewide (where applicable)
Alcohol and /or Drug Screening, Testing, Treatment 4588 15 min $39.70 $47.38 N/A
Developmental Test Administration 4589 15 min $29.30 $34.97 N/A
Psychotherapy (Individual and Family) 4590 15 min $33.57 $40.06 N/A
Psychotherapy Group 4591 15 min $11.63 $12.92 N/A
Neuropsychological Testing/Evaluation Services 4592 15 min $32.56 $38.86 N/A
Psychiatric Diagnostic Examination 4593 15 min $48.84 $58.28 N/A
Office Visit 4594 15 min $48.26 $63.04 N/A
Smoking Cessation treatment 4595 15 min $17.95 $21.41 N/A
ECG 4596 Per occurrence N/A N/A $15.00
Screening - Developmental/Emotional/Behavioral 4597 Per occurrence $59.08 $70.50 N/A
Hearing and Evaluation of Speech 4598 15 min N/A N/A $8.29
Immunization (Administration) 4599 Per occurrence N/A N/A $17.85
Lab: Lithium 4600 Per Laboratory Procedure N/A N/A $8.00
Lab: Urinalysis, by dip stick or tablet reagent Lab: Urinalysis, by dip stick or tablet reagent Lab: Urinalysis; Bacterium scree, except B 4671 Per Laboratory Procedure N/A N/A $2.00
Infectious agent antigen detection by immunoassay technique (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID19]) 4672 Per Laboratory Procedure N/A N/A $45.23
Lab: Urine pregnancy test, by visual color comparison methods 4674 Per Laboratory Procedure N/A N/A $2.00
Lab: Hemoglobin; glycosylated (A1C) 4675 Per Laboratory Procedure N/A N/A $11.00
Blood count; Hemoglobin (HGB) 4676 Per Laboratory Procedure N/A N/A $2.00
Lab: Antibody; HIV-1 4677 Per Laboratory Procedure N/A N/A $11.00
Lab: Smear, primary source with Interpretation 4678 Per Laboratory Procedure N/A N/A $4.00
Lab: Infectious agent detection by nucleic ac 4679 Per Laboratory Procedure N/A N/A $97.00
Lab: Infectious agent detection by immunoassay 4680 Per Laboratory Procedure N/A N/A $4.00
Lab: Infectious agent antigen detection by IM (Influenza rapid test) 4681 Per Laboratory Procedure N/A N/A $15.00
Lab: Molecular PCR Test 4682 Per Laboratory Procedure N/A N/A $51.31
COVID-19 Specimen Collection (can be reimbursed if specimen collection is a standalone service not associated with an office visit or a COVID-19 Molecular PCR test). 4683 Per Laboratory Procedure N/A N/A $23.46
Tuberculosis (TB) tests 4684 Per Laboratory Procedure N/A N/A $5.00
Child and Family Treatment and Support Services Refer to https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/billing.htm
Home and Community Based Services Refer to https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/billing.htm