Freestanding Article 28 Rate Codes Subsumed by APGs

Prior to date subsumed, claims should be billed using rate codes below. Once rate codes subsumed, bill with appropriate APG rate code.

Rate
Code
Rate Code Description Date
Subsumed
Notes
1226 FITTING OF SPECTACLES; MONOFOCAL; BIFOCAL; MULTIFOCAL 1/1/2011
1227 FITTING OF SPECTACLES PLUS EYEGLASS MATERIAL 1/1/2011
1601 D&T PCAP INITIAL PRENATAL CARE VISIT 9/1/2009
1602 D&T PCAP FOLLOW-UP PRENATAL CARE VISIT 9/1/2009
1603 D&T PCAP POST-PARTUM CARE 9/1/2009
1610 ALL INCLUSIVE 9/1/2009
1611 ABORTION 9/1/2009
1612 HOME TRANSFUSION 9/1/2009
1616 CHC,WCC,PEDIATRIC 9/1/2009
1617 FAMILY PLANNING 9/1/2009
1620 DENTAL 9/1/2009
1622 INITIAL VISIT (CLINIC) 9/1/2009
1623 ANTEPARTUM VISIT 9/1/2009
1624 LABOR 9/1/2009
1626 POSTPARTUM HOME AND OFFICE VISITS 9/1/2009
1627 COMP PHYS EXAM (SCHOOL HEALTH PROJECT) 9/1/2009
1628 ROUTINE VISIT (SCHOOL HEALTH PROJ) 9/1/2009
1629 PART-TIME CLINIC SERVICES 9/1/2009
1638 TB CLINIC, CLS III PT DESIGNATION, INC PHYS 9/1/2009
1640 TB CLINIC, CLS II PT DESIGNATION 9/1/2009
1641 HEMODIALYSIS FACILITY SESSION 9/1/2009
1642 HOME HEMODIALYSIS CAPD/CCPD WEEKLY 9/1/2009
1643 HOME HEMODIALYSIS CAPD/CCPD DAILY 9/1/2009
1695 HIV COUNSELING AND TESTING VISIT 7/1/2011
1696 POST-TEST HIV COUNSELING VISIT - NEGATIVE RESULTS 9/1/2009
1697 INITIAL COMP HIV MEDICAL EVALUATION VISIT 9/1/2009
1698 DRUG/IMMUNOTHERAPY VISIT - HIV INFECTED PT. 9/1/2009
1699 MONITORING VISIT - ASYMPTOMATIC HIV DISEASE 9/1/2009
1701 PAS 1 - NERVE REPAIR 9/1/2009
1702 PAS 2 - EYE THERAPEUTIC 9/1/2009
1703 PAS 3 - EYE REPAIR 9/1/2009
1704 PAS 4 - LENS REMOVE/REPLACE 9/1/2009
1705 PAS 5 - EYE LASER THERAPEUTIC 9/1/2009
1706 PAS 6 - EYE MUSCLE REPAIR 9/1/2009
1707 PAS 7 - EYE REPAIR 9/1/2009
1708 PAS 8 - EAR THERAPEUTIC 9/1/2009
1709 PAS 9 - NASAL/PARANASAL THERAPEUTIC 9/1/2009
1710 PAS 10 - RHINO/SEPTO PLASTY 9/1/2009
1711 PAS 11 - TONSIL/ADENOID THERAPEUTIC 9/1/2009
1712 PAS 12 - NASAL/TRACHEAL ENDOSCOPE 9/1/2009
1713 PAS 13 - THORACIC DIAGNOSTIC/THERAPEUTIC 9/1/2009
1714 PAS 14 - VASCULAR DIAGNOSTIC II 9/1/2009
1715 PAS 15 - VASCULAR REPAIR 9/1/2009
1716 PAS 16 - VASCULAR DIAGNOSTIC/THERAPEUTIC 9/1/2009
1717 PAS 17 - UPPER G.I. DIAGNOSTIC/THERAPEUTIC 9/1/2009
1718 PAS 18 - LOWER G.I. DIAGNOSTIC/THERAPEUTIC 9/1/2009
1719 PAS 19 - RECTAL DIAGNOSTIC/THERAPEUTIC 9/1/2009
1720 PAS 20 - HEPATIC DIAGNOSTIC/THERAPEUTIC 9/1/2009
1721 PAS 21 - HEPATIC ENDOSCOPY 9/1/2009
1722 PAS 22 - HERNIA REPAIR 9/1/2009
1723 PAS 23 - CYSTOSCOPE 9/1/2009
1724 PAS 24 - UROLOGICAL THERAPEUTIC 9/1/2009
1725 PAS 25 - LITHOTRIPSY 9/1/2009
1726 PAS 26 - MALE GENITAL DIAGNOSTIC 9/1/2009
1727 PAS 27 - GENITO-URINARY REPAIR 9/1/2009
1728 PAS 28 - MALE GENITAL THERAPEUTIC 9/1/2009
1729 PAS 29 - LAPAROSCOPY 9/1/2009
1730 PAS 30 - OVIDUCT DIAGNOSTIC/THERAPEUTIC 9/1/2009
1731 PAS 31 - GYN DIAGNOSTIC/THERAPEUTIC 9/1/2009
1732 PAS 32 - DILATION AND CURETTAGE 9/1/2009
1733 PAS 33 - SOFT TISSUE REPAIR 9/1/2009
1734 PAS 34 - BONE THERAPEUTIC 9/1/2009
1735 PAS 35 - ARTHROSCOPY 9/1/2009
1736 PAS 36 - BONE REPAIR 9/1/2009
1737 PAS 37 - SOFT TISSUE THERAPY 9/1/2009
1738 PAS 38 - BREAST DIAGNOSTIC/THERAPEUTIC 9/1/2009
1739 PAS 39 - BREAST REPAIR 9/1/2009
1740 PAS 40 - SKIN DIAGNOSTIC/THERAPEUTIC 9/1/2009
1741 PAS 41 - SKIN REPAIR 9/1/2009
1742 PAS 42 - UROLOGICAL DIAGNOSTIC 9/1/2009
1743 ADDITIONAL SURGERY - PAS 1 9/1/2009
1744 ADDITIONAL SURGERY - PAS 2 9/1/2009
1745 ADDITIONAL SURGERY - PAS 3 9/1/2009
1746 ADDITIONAL SURGERY - PAS 4 9/1/2009
1747 ADDITIONAL SURGERY - PAS 5 9/1/2009
1748 ADDITIONAL SURGERY - PAS 6 9/1/2009
1749 ADDITIONAL SURGERY - PAS 7 9/1/2009
1750 ADDITIONAL SURGERY - PAS 8 9/1/2009
1751 ADDITIONAL SURGERY - PAS 9 9/1/2009
1752 ADDITIONAL SURGERY - PAS 10 9/1/2009
1753 ADDITIONAL SURGERY - PAS 11 9/1/2009
1754 ADDITIONAL SURGERY - PAS 12 9/1/2009
1755 ADDITIONAL SURGERY - PAS 13 9/1/2009
1756 ADDITIONAL SURGERY - PAS 14 9/1/2009
1757 ADDITIONAL SURGERY - PAS 15 9/1/2009
1758 ADDITIONAL SURGERY - PAS 16 9/1/2009
1759 ADDITIONAL SURGERY - PAS 17 9/1/2009
1760 ADDITIONAL SURGERY - PAS 18 9/1/2009
1761 ADDITIONAL SURGERY - PAS 19 9/1/2009
1762 ADDITIONAL SURGERY - PAS 20 9/1/2009
1763 ADDITIONAL SURGERY - PAS 21 9/1/2009
1764 ADDITIONAL SURGERY - PAS 22 9/1/2009
1765 ADDITIONAL SURGERY - PAS 23 9/1/2009
1766 ADDITIONAL SURGERY - PAS 24 9/1/2009
1767 ADDITIONAL SURGERY - PAS 25 9/1/2009
1768 ADDITIONAL SURGERY - PAS 26 9/1/2009
1769 ADDITIONAL SURGERY - PAS 27 9/1/2009
1770 ADDITIONAL SURGERY - PAS 28 9/1/2009
1771 ADDITIONAL SURGERY - PAS 29 9/1/2009
1772 ADDITIONAL SURGERY - PAS 30 9/1/2009
1773 ADDITIONAL SURGERY - PAS 31 9/1/2009
1774 ADDITIONAL SURGERY - PAS 32 9/1/2009
1775 ADDITIONAL SURGERY - PAS 33 9/1/2009
1776 ADDITIONAL SURGERY - PAS 34 9/1/2009
1777 ADDITIONAL SURGERY - PAS 35 9/1/2009
1778 ADDITIONAL SURGERY - PAS 36 9/1/2009
1779 ADDITIONAL SURGERY - PAS 37 9/1/2009
1780 ADDITIONAL SURGERY - PAS 38 9/1/2009
1781 ADDITIONAL SURGERY - PAS 39 9/1/2009
1782 ADDITIONAL SURGERY - PAS 40 9/1/2009
1783 ADDITIONAL SURGERY - PAS 41 9/1/2009
1784 ADDITIONAL SURGERY - PAS 42 9/1/2009
1802 POST-TEST HIV COUNSELING VST - POSITIVE RESULTS 7/1/2011
1804 PAS GROUPER ACCESS CODE-PRINCIPAL PROCEDURE 9/1/2009
1805 PAS GROUPER ACCESS CODE-ADDITIONAL PROCEDURE 9/1/2009
1806 HEMO, EPO ADD-ON PER 1,000 UNITS 9/1/2009
2883 RENAL OR HEMODIALYSIS 9/1/2009
3092 CHEMO CLINIC SERVICE 9/1/2009
3109 HIV COUNSELING VISIT (NO TESTING) 7/1/2011
3110 CHAP SCREENING EXAMINATION 9/1/2009
4013 FQHC INDIVIDUAL THRESHOLD VISIT[1] 9/1/2009 Only subsumed for FQHCs that opted into APGs
6501 PAC 1 DIAGNOSTIC INVESTIGATION EXAMS NEC 9/1/2009
6502 PAC 2 DIAGNOSTIC INVEST WITH NUCL IMAGING 9/1/2009
6503 PAC 3 DIAGNOSTIC INVEST WITH CAT IMAGING 9/1/2009
6504 PAC 4 DIAGNOSTIC INVEST WITH MRI 9/1/2009
6505 PAC 5 MANAGEMENT EXAM NEC 9/1/2009
6506 PAC 6 MEDICATION ADMINISTRATION 9/1/2009
6507 PAC 7 PEDITRC ANUAL WELCARE EXAM (AGE 3-17) 9/1/2009
6508 PAC 8 ADULT ANUAL WELL CARE EXAM (AGE >17) 9/1/2009
6509 PAC 9 FIRST PRENATAL - ROUTINE 9/1/2009
6510 PAC 10 FIRST PRENATAL - COMPLICATED 9/1/2009
6511 PAC 11 PRENATAL MGMNT REVISIT - COMPLICATED 9/1/2009
6512 PAC 12 POST PARTUM MGMNT - COMPLICATED 9/1/2009
6513 PAC 13 PRENATAL REVISIT WELL CARE - NORMAL 9/1/2009
6514 PAC 14 POST PARTUM MGMNT - NORMAL 9/1/2009
6515 PAC 15 NEONATAL & CONGENITAL DIAG INVEST 9/1/2009
6516 PAC 16 MGMNT OF NEONATAL & CONGENITL PROB 9/1/2009
6517 PAC 17 PEDIATRIC WELL CARE EXAM (AGE <3) 9/1/2009
6518 PAC 18 FEMALE REPRODUCTIVE DIAG INVEST 9/1/2009
6519 PAC 19 MGMNT OF FEMALE REPRODUCTIVE PROB 9/1/2009
6520 PAC 20 ANNUAL GYNECOLOGICAL EXAM 9/1/2009
6521 PAC 21 CONTRACEPTIVE WELL CARE EXAM 9/1/2009
6522 PAC 22 ENT DIAG INVEST-ADULT (AGE >17) 9/1/2009
6523 PAC 23 ENT DIAG INVEST-PEDIA (AGE 0-17) 9/1/2009
6524 PAC 24 MGMNT OF ENT PROB-ADULT (AGE >17) 9/1/2009
6525 PAC 25 MGMNT OF ENT PROB-PEDIA (AGE 0-17) 9/1/2009
6526 PAC 26 OPHTHALMOLOGICAL SERVICES 9/1/2009
6527 PAC 27 RESPRATRY DIAG INVEST-ADLT (AGE>17) 9/1/2009
6528 PAC 28 RESP DIAG INVEST-PEDIA (AGE 0-17) 9/1/2009
6529 PAC 29 MGMNT OF RESP PROB-ADULT (AGE>17) 9/1/2009
6530 PAC 30 MGMNT OF RESP PROB-PEDIA (AGE 0-17) 9/1/2009
6531 PAC 31 SYSTEMIC INFECTION DIAG INVEST 9/1/2009
6532 PAC 32 MGMNT OF SYSTEMIC INFECTIONS 9/1/2009
6533 PAC 33 GASTROINTESTINAL DIAG INVEST 9/1/2009
6534 PAC 34 MGMT GSTRONTSTNL PROB-ADLT (AGE >17) 9/1/2009
6535 PAC 35 MGMT GSTRONTSTNL PROB-PED (AGE 0-17) 9/1/2009
6536 PAC 36 HEPATOBILIARY DIAG INVESTIGATION 9/1/2009
6537 PAC 37 MGMNT OF HEPATOBILIARY PROB 9/1/2009
6538 PAC 38 GENITO-UROLOGICAL DIAG INVEST 9/1/2009
6539 PAC 39 MGMNT OF GENITO-UROLOGICAL PROB 9/1/2009
6540 PAC 40 CARDIAC DIAG INVESTIGATION 9/1/2009
6541 PAC 41 MANAGEMENT OF CARDIAC PROB 9/1/2009
6542 PAC 42 ENDOCRINAL DIAG INVESTIGATION 9/1/2009
6543 PAC 43 MGMNT OF OTHER ENDOCRINAL PROB 9/1/2009
6544 PAC 44 MGMT OF DIABETES-PEDIATRC (AGE 0-17) 9/1/2009
6545 PAC 45 MGMNT OF DIABETES-ADULT (AGE >17) 9/1/2009
6546 PAC 46 SKIN & SOFT TISSUE DIAG INVEST 9/1/2009
6547 PAC 47 INFLAMMATORY MUSC/SKEL DIAG INVEST 9/1/2009
6548 PAC 48 OTHER MUSC/SKEL DIAG INVESTIGATION 9/1/2009
6549 PAC 49 REHABILITATION THERAPY 9/1/2009
6550 PAC 50 MGMNT OF SKIN & SOFT TISSUE PROB 9/1/2009
6551 PAC 51 MANAGEMENT OF POISONING 9/1/2009
6552 PAC 52 MGMNT OF INFLAMM MUSC/SKEL PROB 9/1/2009
6553 PAC 53 MGMNT OF OTHER MUSC/SKEL PROB 9/1/2009
6554 PAC 54 ONCOLOGICAL DIAG INVESTIGATION 9/1/2009
6555 PAC 55 AIDS DIAG INVESTIGATION 9/1/2009
6556 PAC 56 OTHER HEMATOLOGICAL DIAG INVEST 9/1/2009
6557 PAC 57 THERAPEUTIC IV PUSH & CHEMO INJECT 9/1/2009
6558 PAC 58 THERAPEUTIC INFUSIONS 9/1/2009
6559 PAC 59 THERAPEUTIC RADIOTHERAPY 9/1/2009
6560 PAC 60 ONCOLOGICAL MANAGEMENT 9/1/2009
6561 PAC 61 MGMT OF ANEMIAS-PEDIATRC (AGE 0-17) 9/1/2009
6562 PAC 62 MGMT OF ANEMIAS-ADULT (AGE >17) 9/1/2009
6563 PAC 63 MGMT OF AIDS-PEDIATRIC (AGE 0-17) 9/1/2009
6564 PAC 64 MGMT OF AIDS-ADULT (AGE>17) 9/1/2009
6565 PAC 65 MGMNT OF OTHER HEMATOLOGICAL PROB 9/1/2009
6566 PAC 66 NEURO & PSYCHO/SOCIAL DIAG INVEST 9/1/2009
6567 PAC 67 SPEECH & HEARNG SVCS-ADULT (AGE >17) 9/1/2009
6568 PAC 68 SPECH & HEARNGSVCS-PEDIA (AGE 0-17) 9/1/2009
6569 PAC 69 NEUROLOGICAL & PSYCHO/SOCIAL MGMNT 9/1/2009
6570 PAC 70 COUNSELING 9/1/2009
6571 PAC 71 DIAG INVEST OF VASCULAR SYSTEMS 9/1/2009
7501 PAC 1 MEDICARE CLAIM 9/1/2009
7502 PAC 2 MEDICARE CLAIM 9/1/2009
7503 PAC 3 MEDICARE CLAIM 9/1/2009
7504 PAC 4 MEDICARE CLAIM 9/1/2009
7505 PAC 5 MEDICARE CLAIM 9/1/2009
7506 PAC 6 MEDICARE CLAIM 9/1/2009
7508 PAC 8 MEDICARE CLAIM 9/1/2009
7509 PAC 9 MEDICARE CLAIM 9/1/2009
7510 PAC 10 MEDICARE CLAIM 9/1/2009
7511 PAC 11 MEDICARE CLAIM 9/1/2009
7512 PAC 12 MEDICARE CLAIM 9/1/2009
7513 PAC 13 MEDICARE CLAIM 9/1/2009
7514 PAC 14 MEDICARE CLAIM 9/1/2009
7515 PAC 15 MEDICARE CLAIM 9/1/2009
7516 PAC 16 MEDICARE CLAIM 9/1/2009
7517 PAC 17 MEDICARE CLAIM 9/1/2009
7518 PAC 18 MEDICARE CLAIM 9/1/2009
7519 PAC 19 MEDICARE CLAIM 9/1/2009
7520 PAC 20 MEDICARE CLAIM 9/1/2009
7521 PAC 21 MEDICARE CLAIM 9/1/2009
7522 PAC 22 MEDICARE CLAIM 9/1/2009
7524 PAC 24 MEDICARE CLAIM 9/1/2009
7525 PAC 25 MEDICARE CLAIM 9/1/2009
7526 PAC 26 MEDICARE CLAIM 9/1/2009
7527 PAC 27 MEDICARE CLAIM 9/1/2009
7529 PAC 29 MEDICARE CLAIM 9/1/2009
7530 PAC 30 MEDICARE CLAIM 9/1/2009
7531 PAC 31 MEDICARE CLAIM 9/1/2009
7532 PAC 32 MEDICARE CLAIM 9/1/2009
7533 PAC 33 MEDICARE CLAIM 9/1/2009
7534 PAC 34 MEDICARE CLAIM 9/1/2009
7535 PAC 35 MEDICARE CLAIM 9/1/2009
7536 PAC 36 MEDICARE CLAIM 9/1/2009
7537 PAC 37 MEDICARE CLAIM 9/1/2009
7538 PAC 38 MEDICARE CLAIM 9/1/2009
7539 PAC 39 MEDICARE CLAIM 9/1/2009
7540 PAC 40 MEDICARE CLAIM 9/1/2009
7541 PAC 41 MEDICARE CLAIM 9/1/2009
7542 PAC 42 MEDICARE CLAIM 9/1/2009
7543 PAC 43 MEDICARE CLAIM 9/1/2009
7544 PAC 44 MEDICARE CLAIM 9/1/2009
7545 PAC 45 MEDICARE CLAIM 9/1/2009
7546 PAC 46 MEDICARE CLAIM 9/1/2009
7547 PAC 47 MEDICARE CLAIM 9/1/2009
7548 PAC 48 MEDICARE CLAIM 9/1/2009
7549 PAC 49 MEDICARE CLAIM 9/1/2009
7550 PAC 50 MEDICARE CLAIM 9/1/2009
7551 PAC 51 MEDICARE CLAIM 9/1/2009
7552 PAC 52 MEDICARE CLAIM 9/1/2009
7553 PAC 53 MEDICARE CLAIM 9/1/2009
7554 PAC 54 MEDICARE CLAIM 9/1/2009
7555 PAC 55 MEDICARE CLAIM 9/1/2009
7556 PAC 56 MEDICARE CLAIM 9/1/2009
7557 PAC 57 MEDICARE CLAIM 9/1/2009
7558 PAC 58 MEDICARE CLAIM 9/1/2009
7559 PAC 59 MEDICARE CLAIM 9/1/2009
7560 PAC 60 MEDICARE CLAIM 9/1/2009
7561 PAC 61 MEDICARE CLAIM 9/1/2009
7562 PAC 62 MEDICARE CLAIM 9/1/2009
7564 PAC 64 MEDICARE CLAIM 9/1/2009
7565 PAC 65 MEDICARE CLAIM 9/1/2009
7566 PAC 66 MEDICARE CLAIM 9/1/2009
7567 PAC 67 MEDICARE CLAIM 9/1/2009
7568 PAC 68 MEDICARE CLAIM 9/1/2009
7569 PAC 69 MEDICARE CLAIM 9/1/2009
7570 PAC 70 MEDICARE CLAIM 9/1/2009
7571 PAC 71 MEDICARE CLAIM 9/1/2009

Please Note

Some documents on this page are saved in the Portable Document Format (PDF). If it's not already on your computer, you'll need to download the latest free version of Adobe Reader.

Some documents on this page are saved as Microsoft Excel files (xls). If you don't have this program on your computer, you can download the free Excel Viewer to view these files.