Fee Schedule

10000 Series Codes	Surgery/Integumentary System and Anesthesia
20000 Series Codes	Surgery/Musculoskeletal System
30000 Series Codes	Surgery/Respiratory System, Surgery/Cardiovascular System, and Surgery/Hemic & Lymphatic Systems
40000 Series Codes	Surgery/Disgestive System
50000 Series Codes	Surgery/Urinary System, Surgery/Male Genital System, Surgery/Female Genital System, and Maternity Care & Delivery
60000 Series Codes	Surgery/Endoctrine System, Surgery/Nervous System, Surgery/Eye & Ocular Adnexa, and Surgery/Auditory System
70000 Series Codes	Radiology/Diagnostic Radiology (Diagnostic Imaging)
80000 Series Codes	Pathology and Laboratory
90000 Series Codes	Medical Management
A Codes	Transportation Services (including Ambulance) and Medical & Surgical Supplies
B Codes	Enteral & Parenteral Therapy
C Codes	Pass-Through Items
D Codes	Dental Procedures
E Codes	Durable Medical Equipment
G Codes	Procedure/Professional Services
H Codes	Alcohol & Drug Abuse Treatment Services
J Codes	Drugs Administered Other Than Oral Method and Chemotherapy Drugs
K Codes	DME Supplies (Temporary Codes)
L Codes	Orthotic and Prosthetic Procedures
M Codes	Medical Services
P Codes	Laboratory and Pathology
Q Codes	Temporary Codes
R Codes	Diagnostic Radiology Services
S Codes	Temporary National Codes (Non-Medical)
T Codes	National Codes Established for State Medicaid Agencies
V Codes	Vision and Hearing Services
X Codes	State Only Codes
Y Codes	State Only Codes

* Last Update (August 2011)

Please Note:

• The rates listed are the Base Medicaid Rates
• When the rate is listed as $0, then the claim is either priced manually and requires supporting documentation or prices based as percentage
• Codes billed with modifiers may price differently
• Special Programs may have different pricing with the use of modifiers or provider specific certification