Hospital Outpatient Department 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
1616 CHC,WCC,PEDIATRIC 12/1/2008
1617 FAMILY PLANNING 12/1/2008
1620 DENTAL 12/1/2008
1641 HEMODIALYSIS FACILITY SESSION 12/1/2008
2870 OUTPATIENT DEPT 12/1/2008
2875 FAMILY MEDICINE 12/1/2008
2879 GENERAL - ER 1/1/2009
2880 PART-TIME CLINIC SERVICES 12/1/2008
2883 RENAL OR HEMODIALYSIS 12/1/2008
2888 COMPREHENSIVE PHYSICAL EXAM (SCHOOL HEALTH PROJECT) 10/1/2009
2889 ROUTINE VISIT (SCHOOL HEALTH PROJECT) 10/1/2009
2910 HEMODIALYSIS FACILITY SESSION 12/1/2008
2911 HOME HEMODIALYSIS CAPD/CCPD WEEKLY 12/1/2008
2912 HOME HEMODIALYSIS CAPD/CCPD DAILY 12/1/2008
2914 HOME HEMODIALYSIS EXTENDED PERITONEAL 20-29 HOURS 12/1/2008
2940 AIDS CLINIC, INITIAL VISIT 12/1/2008
2941 AIDS CLINIC, FOLLOW-UP VISIT, EXTENDED 12/1/2008
2942 AIDS CLINIC, FOLLOW-UP VISIT (ROUTINE) 12/1/2008
2944 AIDS CLINIC, INFUSION THERAPY (CHEMOTHERAPY) 12/1/2008
2945 AIDS CLINIC, SUBSEQUENT COMPREHENSVE VISIT 12/1/2008
2983 HIV COUNSELING AND TESTING VISIT 7/1/2011
2984 POST-TEST HIV COUNSELING VISIT-NEG RESULT 12/1/2008
2985 INITIAL COMP HIV MEDICAL EVAL VISIT 12/1/2008
2986 DRUG/IMMUNOTHERAPY VST-HIV IFECTED PT. 12/1/2008
2987 MONITORING VST-ASYMPTOMATIC HIV DISEASE 12/1/2008
2988 AIDS DENTAL CLINIC VISIT 12/1/2008
2989 OB HIV COUNSLG/TESTING-UNREGISTERED PTS 12/1/2008
3001 PAS 1 - NERVE REPAIR 12/1/2008
3002 PAS 2 - EYE THERAPEUTIC 12/1/2008
3003 PAS 3 - EYE REPAIR 12/1/2008
3004 PAS 4 - LENS REMOVE/REPLACE 12/1/2008
3005 PAS 5 - EYE LASER THERAPEUTIC 12/1/2008
3006 PAS 6 - EYE MUSCLE REPAIR 12/1/2008
3007 PAS 7 - EAR REPAIR 12/1/2008
3008 PAS 8 - EAR THERAPEUTIC 12/1/2008
3009 PAS 9 - NASAL/PARANASAL THERAPEUTIC 12/1/2008
3010 PAS 10 - RHINO/SEPTO PLASTY 12/1/2008
3011 PAS 11 - TONSIL/ADENOID THERAPEUTIC 12/1/2008
3012 PAS 12 - NASAL/TRACHEAL ENDOSCOPE 12/1/2008
3013 PAS 13 - THORACIC DIAGNOSTIC/THERAPEUTIC 12/1/2008
3014 PAS 14 - VASCULAR DIAGNOSTIC II 12/1/2008
3015 PAS 15 - VASCULAR REPAIR 12/1/2008
3016 PAS 16 - VASCULAR DIAGNOSTIC/THERAPEUTIC 12/1/2008
3017 PAS 17 - UPPER G.I. DIAGNOSTIC/THERAPEUTIC 12/1/2008
3018 PAS 18 - LOWER G.I. DIAGNOSTIC/THERAPEUTIC 12/1/2008
3019 PAS 19 - RECTAL DIAGNOSTIC/THERAPEUTIC 12/1/2008
3020 PAS 20 - HEPATIC DIAGNOSTIC/THERAPEUTIC 12/1/2008
3021 PAS 21 - HEPATIC ENDOSCOPY 12/1/2008
3022 PAS 22 - HERNIA REPAIR 12/1/2008
3023 PAS 23 - CYSTOSCOPE 12/1/2008
3024 PAS 24 - UROLOGICAL THERAPEUTIC 12/1/2008
3025 PAS 25 - LITHOTRIPSY 12/1/2008
3026 PAS 26 - MALE GENITAL DIAGNOSTIC 12/1/2008
3027 PAS 27 - GENITO-URINARY REPAIR 12/1/2008
3028 PAS 28 - MALE GENITAL THERAPEUTIC 12/1/2008
3029 PAS 29 - LAPAROSCOPY 12/1/2008
3030 PAS 30 - OVIDUCT DIAGNOSTIC/THERAPEUTIC 12/1/2008
3031 PAS 31 - GYN DIAGNOSTIC/THERAPEUTIC 12/1/2008
3032 PAS 32 - DILATION AND CURETTAGE 12/1/2008
3033 PAS 33 - SOFT TISSUE REPAIR 12/1/2008
3034 PAS 34 - BONE THERAPEUTIC 12/1/2008
3035 PAS 35 - ARTHROSCOPY 12/1/2008
3036 PAS 36 - BONE REPAIR 12/1/2008
3037 PAS 37 - SOFT TISSUE THERAPY 12/1/2008
3038 PAS 38 - BREAST DIAGNOSTIC/THERAPEUTIC 12/1/2008
3039 PAS 39 - BREAST REPAIR 12/1/2008
3040 PAS 40 - SKIN DIAGNOSTIC/THERAPEUTIC 12/1/2008
3041 PAS 41 - SKIN REPAIR 12/1/2008
3042 PAS 42 - UROLOGICAL DIAGNOSTIC 12/1/2008
3043 ADDITIONAL SURGERY - PAS 1 12/1/2008
3044 ADDITIONAL SURGERY - PAS 2 12/1/2008
3045 ADDITIONAL SURGERY - PAS 3 12/1/2008
3046 ADDITIONAL SURGERY - PAS 4 12/1/2008
3047 ADDITIONAL SURGERY - PAS 5 12/1/2008
3048 ADDITIONAL SURGERY - PAS 6 12/1/2008
3049 ADDITIONAL SURGERY - PAS 7 12/1/2008
3050 ADDITIONAL SURGERY - PAS 8 12/1/2008
3051 ADDITIONAL SURGERY - PAS 9 12/1/2008
3052 ADDITIONAL SURGERY - PAS 10 12/1/2008
3053 ADDITIONAL SURGERY - PAS 11 12/1/2008
3054 ADDITIONAL SURGERY - PAS 12 12/1/2008
3055 ADDITIONAL SURGERY - PAS 13 12/1/2008
3056 ADDITIONAL SURGERY - PAS 14 12/1/2008
3057 ADDITIONAL SURGERY - PAS 15 12/1/2008
3058 ADDITIONAL SURGERY - PAS 16 12/1/2008
3059 ADDITIONAL SURGERY - PAS 17 12/1/2008
3060 ADDITIONAL SURGERY - PAS 18 12/1/2008
3061 ADDITIONAL SURGERY - PAS 19 12/1/2008
3062 ADDITIONAL SURGERY - PAS 20 12/1/2008
3063 ADDITIONAL SURGERY - PAS 21 12/1/2008
3064 ADDITIONAL SURGERY - PAS 22 12/1/2008
3065 ADDITIONAL SURGERY - PAS 23 12/1/2008
3066 ADDITIONAL SURGERY - PAS 24 12/1/2008
3067 ADDITIONAL SURGERY - PAS 25 12/1/2008
3068 ADDITIONAL SURGERY - PAS 26 12/1/2008
3069 ADDITIONAL SURGERY - PAS 27 12/1/2008
3070 ADDITIONAL SURGERY - PAS 28 12/1/2008
3071 ADDITIONAL SURGERY - PAS 29 12/1/2008
3072 ADDITIONAL SURGERY - PAS 30 12/1/2008
3073 ADDITIONAL SURGERY - PAS 31 12/1/2008
3074 ADDITIONAL SURGERY - PAS 32 12/1/2008
3075 ADDITIONAL SURGERY - PAS 33 12/1/2008
3076 ADDITIONAL SURGERY - PAS 34 12/1/2008
3077 ADDITIONAL SURGERY - PAS 35 12/1/2008
3078 ADDITIONAL SURGERY - PAS 36 12/1/2008
3079 ADDITIONAL SURGERY - PAS 37 12/1/2008
3080 ADDITIONAL SURGERY - PAS 38 12/1/2008 Only subsumed for FQHCs that opted into APGs
3081 ADDITIONAL SURGERY - PAS 39 12/1/2008
3082 ADDITIONAL SURGERY - PAS 40 12/1/2008
3083 ADDITIONAL SURGERY - PAS 41 12/1/2008
3084 ADDITIONAL SURGERY - PAS 42 12/1/2008
3085 PAS 43 - ORAL SURGERY 12/1/2008
3086 ADDITIONAL SURGERY - PAS 43 12/1/2008
3089 PAS GROUPER ACCESS CODE-PRINCIPAL PROC 12/1/2008
3090 PAS GROUPER ACCESS CODE-ADDITIONAL PROC0 12/1/2008
3092 CHEMO CLINIC SERVICE 12/1/2008
3093 PAS 44 - STEREOTACTIC RAD THER OF BRAIN 12/1/2008
3095 PAS 45 VITRECTOMY WITH THERAPY DRUG IMP 12/1/2008
3096 ADDITIONAL SURGERY - PAS 45 12/1/2008
3098 HYPERBARIC TREATMENT 12/1/2008
3099 HEAD INJURY/TRAUMA CLINIC 12/1/2008
3100 ORTHOPEDIC REHAB CLINIC 12/1/2008
3101 HOSP-BASED PCAP INITIAL PRENATAL CARE VISIT 12/1/2008
3102 HOSP-BASED PCAP FOLLOW-UP PRENATAL VISIT 12/1/2008
3103 HOSPITAL-BASED PCAP POST-PARTUM CARE 12/1/2008
3104 HEMO, EPO ADD-ON UP TO 10,000 UNITS 12/1/2008
3105 HEMO, EPO ADD-ON 10,000 UNITS OR MORE 12/1/2008
3106 HEMO, EPO ADD-ON PER 1,000 UNIT 12/1/2008
3109 HIV COUNSELING VISIT (NO TESTING) 7/1/2011
3110 CHAP SCREENING EXAMINATION 12/1/2008
3111 POST-TEST HIV COUNSELING VISIT-POS RESULT 7/1/2011
3112 AIDS CLINIC, INFUS. THERAPY-1 UNIT BLOOD 12/1/2008
3113 AIDS CLINIC, INFUS. THERAPY-2 UNITS BLOOD 12/1/2008
3114 AIDS CLINIC, INFUS. THERAPY-3 UNITS BLOOD 12/1/2008
3115 AIDS CLINIC, INFUS. THERAPY-4 UNITS BLOOD 12/1/2008
3139 NEWBORN HEARING SCRNG SVC - 2ND/FOLLOWUP STAGE 7/1/2010
3140 HYPERBARIC THERAPY - 1/2 HOUR 12/1/2008
4013 FQHC INDIVIDUAL THRESHOLD VISIT 12/1/2008 Only subsumed for FQHCs that opted into APGs
6501 PAC 1 DIAGNOSTIC INVESTIGATION EXAMS NEC 12/1/2008
6502 PAC 2 DIAGNOSTIC INVEST WITH NUCL IMAGING 12/1/2008
6503 PAC 3 DIAGNOSTIC INVEST WITH CAT IMAGING 12/1/2008
6504 PAC 4 DIAGNOSTIC INVEST WITH MRI 12/1/2008
6505 PAC 5 MANAGEMENT EXAM NEC 12/1/2008
6506 PAC 6 MEDICATION ADMINISTRATION 12/1/2008
6507 PAC 7 PEDITRC ANUAL WELCARE EXAM (AGE 3-17) 12/1/2008
6508 PAC 8 ADULT ANUAL WELL CARE EXAM (AGE >17) 12/1/2008
6509 PAC 9 FIRST PRENATAL - ROUTINE 12/1/2008
6510 PAC 10 FIRST PRENATAL - COMPLICATED 12/1/2008
6511 PAC 11 PRENATAL MGMNT REVISIT - COMPLICATED 12/1/2008
6512 PAC 12 POST PARTUM MGMNT - COMPLICATED 12/1/2008
6513 PAC 13 PRENATAL REVISIT WELL CARE - NORMAL 12/1/2008
6514 PAC 14 POST PARTUM MGMNT - NORMAL 12/1/2008
6515 PAC 15 NEONATAL & CONGENITAL DIAG INVEST 12/1/2008
6516 PAC 16 MGMNT OF NEONATAL & CONGENITL PROB 12/1/2008
6517 PAC 17 PEDIATRIC WELL CARE EXAM (AGE <3) 12/1/2008
6518 PAC 18 FEMALE REPRODUCTIVE DIAG INVEST 12/1/2008
6519 PAC 19 MGMNT OF FEMALE REPRODUCTIVE PROB 12/1/2008
6520 PAC 20 ANNUAL GYNECOLOGICAL EXAM 12/1/2008
6521 PAC 21 CONTRACEPTIVE WELL CARE EXAM 12/1/2008
6522 PAC 22 ENT DIAG INVEST-ADULT (AGE >17) 12/1/2008
6523 PAC 23 ENT DIAG INVEST-PEDIA (AGE 0-17) 12/1/2008
6524 PAC 24 MGMNT OF ENT PROB-ADULT (AGE >17) 12/1/2008
6525 PAC 25 MGMNT OF ENT PROB-PEDIA (AGE 0-17) 12/1/2008
6526 PAC 26 OPHTHALMOLOGICAL SERVICES 12/1/2008
6527 PAC 27 RESPRATRY DIAG INVEST-ADLT (AGE>17) 12/1/2008
6528 PAC 28 RESP DIAG INVEST-PEDIA (AGE 0-17) 12/1/2008
6529 PAC 29 MGMNT OF RESP PROB-ADULT (AGE>17) 12/1/2008
6530 PAC 30 MGMNT OF RESP PROB-PEDIA (AGE 0-17) 12/1/2008
6531 PAC 31 SYSTEMIC INFECTION DIAG INVEST 12/1/2008
6532 PAC 32 MGMNT OF SYSTEMIC INFECTIONS 12/1/2008
6533 PAC 33 GASTROINTESTINAL DIAG INVEST 12/1/2008
6534 PAC 34 MGMT GSTRONTSTNL PROB-ADLT (AGE >17) 12/1/2008
6535 PAC 35 MGMT GSTRONTSTNL PROB-PED (AGE 0-17) 12/1/2008
6536 PAC 36 HEPATOBILIARY DIAG INVESTIGATION 12/1/2008
6537 PAC 37 MGMNT OF HEPATOBILIARY PROB 12/1/2008
6538 PAC 38 GENITO-UROLOGICAL DIAG INVEST 12/1/2008
6539 PAC 39 MGMNT OF GENITO-UROLOGICAL PROB 12/1/2008
6540 PAC 40 CARDIAC DIAG INVESTIGATION 12/1/2008
6541 PAC 41 MANAGEMENT OF CARDIAC PROB 12/1/2008
6542 PAC 42 ENDOCRINAL DIAG INVESTIGATION 12/1/2008
6543 PAC 43 MGMNT OF OTHER ENDOCRINAL PROB 12/1/2008
6544 PAC 44 MGMT OF DIABETES-PEDIATRC (AGE 0-17) 12/1/2008
6545 PAC 45 MGMNT OF DIABETES-ADULT (AGE >17) 12/1/2008
6546 PAC 46 SKIN & SOFT TISSUE DIAG INVEST 12/1/2008
6547 PAC 47 INFLAMMATORY MUSC/SKEL DIAG INVEST 12/1/2008
6548 PAC 48 OTHER MUSC/SKEL DIAG INVESTIGATION 12/1/2008
6549 PAC 49 REHABILITATION THERAPY 12/1/2008
6550 PAC 50 MGMNT OF SKIN & SOFT TISSUE PROB 12/1/2008
6551 PAC 51 MANAGEMENT OF POISONING 12/1/2008
6552 PAC 52 MGMNT OF INFLAMM MUSC/SKEL PROB 12/1/2008
6553 PAC 53 MGMNT OF OTHER MUSC/SKEL PROB 12/1/2008
6554 PAC 54 ONCOLOGICAL DIAG INVESTIGATION 12/1/2008
6555 PAC 55 AIDS DIAG INVESTIGATION 12/1/2008
6556 PAC 56 OTHER HEMATOLOGICAL DIAG INVEST 12/1/2008
6557 PAC 57 THERAPEUTIC IV PUSH & CHEMO INJECT 12/1/2008
6558 PAC 58 THERAPEUTIC INFUSIONS 12/1/2008
6559 PAC 59 THERAPEUTIC RADIOTHERAPY 12/1/2008
6560 PAC 60 ONCOLOGICAL MANAGEMENT 12/1/2008
6561 PAC 61 MGMT OF ANEMIAS-PEDIATRC (AGE 0-17) 12/1/2008
6562 PAC 62 MGMT OF ANEMIAS-ADULT (AGE >17) 12/1/2008
6563 PAC 63 MGMT OF AIDS-PEDIATRIC (AGE 0-17) 12/1/2008
6564 PAC 64 MGMT OF AIDS-ADULT (AGE>17) 12/1/2008
6565 PAC 65 MGMNT OF OTHER HEMATOLOGICAL PROB 12/1/2008
6566 PAC 66 NEURO & PSYCHO/SOCIAL DIAG INVEST 12/1/2008
6567 PAC 67 SPEECH & HEARNG SVCS-ADULT (AGE >17) 12/1/2008
6568 PAC 68 SPECH & HEARNGSVCS-PEDIA (AGE 0-17) 12/1/2008
6569 PAC 69 NEUROLOGICAL & PSYCHO/SOCIAL MGMNT 12/1/2008
6570 PAC 70 COUNSELING 12/1/2008
6571 PAC 71 DIAG INVEST OF VASCULAR SYSTEMS 12/1/2008
7501 PAC 1 MEDICARE CLAIM 12/1/2008
7502 PAC 2 MEDICARE CLAIM 12/1/2008
7503 PAC 3 MEDICARE CLAIM 12/1/2008
7504 PAC 4 MEDICARE CLAIM 12/1/2008
7505 PAC 5 MEDICARE CLAIM 12/1/2008
7506 PAC 6 MEDICARE CLAIM 12/1/2008
7508 PAC 8 MEDICARE CLAIM 12/1/2008
7509 PAC 9 MEDICARE CLAIM 12/1/2008
7510 PAC 10 MEDICARE CLAIM 12/1/2008
7511 PAC 11 MEDICARE CLAIM 12/1/2008
7512 PAC 12 MEDICARE CLAIM 12/1/2008
7513 PAC 13 MEDICARE CLAIM 12/1/2008
7514 PAC 14 MEDICARE CLAIM 12/1/2008
7515 PAC 15 MEDICARE CLAIM 12/1/2008
7516 PAC 16 MEDICARE CLAIM 12/1/2008
7517 PAC 17 MEDICARE CLAIM 12/1/2008
7518 PAC 18 MEDICARE CLAIM 12/1/2008
7519 PAC 19 MEDICARE CLAIM 12/1/2008
7520 PAC 20 MEDICARE CLAIM 12/1/2008
7521 PAC 21 MEDICARE CLAIM 12/1/2008
7522 PAC 22 MEDICARE CLAIM 12/1/2008
7524 PAC 24 MEDICARE CLAIM 12/1/2008
7525 PAC 25 MEDICARE CLAIM 12/1/2008
7526 PAC 26 MEDICARE CLAIM 12/1/2008
7527 PAC 27 MEDICARE CLAIM 12/1/2008
7529 PAC 29 MEDICARE CLAIM 12/1/2008
7530 PAC 30 MEDICARE CLAIM 12/1/2008
7531 PAC 31 MEDICARE CLAIM 12/1/2008
7532 PAC 32 MEDICARE CLAIM 12/1/2008
7533 PAC 33 MEDICARE CLAIM 12/1/2008
7534 PAC 34 MEDICARE CLAIM 12/1/2008
7535 PAC 35 MEDICARE CLAIM 12/1/2008
7536 PAC 36 MEDICARE CLAIM 12/1/2008
7537 PAC 37 MEDICARE CLAIM 12/1/2008
7538 PAC 38 MEDICARE CLAIM 12/1/2008
7539 PAC 39 MEDICARE CLAIM 12/1/2008
7540 PAC 40 MEDICARE CLAIM 12/1/2008
7541 PAC 41 MEDICARE CLAIM 12/1/2008
7542 PAC 42 MEDICARE CLAIM 12/1/2008
7543 PAC 43 MEDICARE CLAIM 12/1/2008
7544 PAC 44 MEDICARE CLAIM 12/1/2008
7545 PAC 45 MEDICARE CLAIM 12/1/2008
7546 PAC 46 MEDICARE CLAIM 12/1/2008
7547 PAC 47 MEDICARE CLAIM 12/1/2008
7548 PAC 48 MEDICARE CLAIM 12/1/2008
7549 PAC 49 MEDICARE CLAIM 12/1/2008
7550 PAC 50 MEDICARE CLAIM 12/1/2008
7551 PAC 51 MEDICARE CLAIM 12/1/2008
7552 PAC 52 MEDICARE CLAIM 12/1/2008
7553 PAC 53 MEDICARE CLAIM 12/1/2008
7554 PAC 54 MEDICARE CLAIM 12/1/2008
7555 PAC 55 MEDICARE CLAIM 12/1/2008
7556 PAC 56 MEDICARE CLAIM 12/1/2008
7557 PAC 57 MEDICARE CLAIM 12/1/2008
7558 PAC 58 MEDICARE CLAIM 12/1/2008
7559 PAC 59 MEDICARE CLAIM 12/1/2008
7560 PAC 60 MEDICARE CLAIM 12/1/2008
7561 PAC 61 MEDICARE CLAIM 12/1/2008
7562 PAC 62 MEDICARE CLAIM 12/1/2008
7564 PAC 64 MEDICARE CLAIM 12/1/2008
7565 PAC 65 MEDICARE CLAIM 12/1/2008
7566 PAC 66 MEDICARE CLAIM 12/1/2008
7567 PAC 67 MEDICARE CLAIM 12/1/2008
7568 PAC 68 MEDICARE CLAIM 12/1/2008
7569 PAC 69 MEDICARE CLAIM 12/1/2008
7570 PAC 70 MEDICARE CLAIM 12/1/2008
7571 PAC 71 MEDICARE CLAIM 12/1/2008

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