APG - Procedure Based Weights History File

Effective Date > Jan 1, 2010 Apr 1, 2010 Jul 1, 2010 Oct 1, 2010
HCPCS Code HCPCS Code Description APG
(ref only)
Px-Based
Weights
Units Limit Px-Based
Weights
Units Limit Px-Based
Weights
Units Limit Px-Based
Weights
Units Limit
55450 Ligation of sperm duct 180
58300 Insert intrauterine device 417
58301 Remove intrauterine device 417
58615 Occlude fallopian tube(s) 197
90805 Psytx, off, 20-30 min w/e&m 315 1.0344 1 1.0344 1 1.0344 1 1.0344 1
90807 Psytx, off, 45-50 min w/e&m 316 1.2413 1 1.2413 1 1.2413 1 1.2413 1
90809 Psytx, off, 75-80, w/e&m 316 1.2413 1 1.2413 1 1.2413 1 1.2413 1
90811 Intact psytx, 20-30, w/e&m 315 1.0344 1 1.0344 1 1.0344 1 1.0344 1
90813 Intact psytx, 45-50 min w/e&m 316 1.2413 1 1.2413 1 1.2413 1 1.2413 1
90815 Intact psytx, 75-80 w/e&m 316 1.2413 1 1.2413 1 1.2413 1 1.2413 1
90819 Psytx, hosp, 45-50 min w/e&m 316 1.2413 1 1.2413 1 1.2413 1 1.2413 1
90833 Psychotherapy, 30 minutes with e&m (code e&m separately) 315 - 0 - 0 - 0 - 0
90836 Psychotherapy, 45 minutes with e&m (code e&m separately) 316 - 0 - 0 - 0 - 0
90838 Psychotherapy, 60 minutes with e&m (code e&m separately) 316 - 0 - 0 - 0 - 0
90847 Family psytx w/patient 317 1.2413 1 1.2413 1 1.2413 1 1.2413 1
90862 Medication management 426 0.8275 1 0.8275 1 0.8275 1 0.6620 1
90863 Pharmacologic management, when performed with psychotherapy. 322 - 0 - 0 - 0 - 0
90882 Environmental manipulation 490 0.2896 1 0.2896 1 0.2896 1 0.2896 1
90993 Dialysis training incompl 428 - 0 - 0 - 0 - 0
92065 Orthoptic/pleoptic training 427 0.3820 1 0.3820 1 0.3820 1 0.3820 1
92340 Fitting of spectacles 490 0.2624 1 0.2624 1 0.2624 1 0.2624 1
92341 Fitting of spectacles 490 0.2624 1 0.2624 1 0.2624 1 0.2624 1
92342 Fitting of spectacles 490 0.2624 1 0.2624 1 0.2624 1 0.2624 1
92506 Speech/hearing evaluation 272
92597 Oral speech device eval 272
92605 Eval for nonspeech device rx 272
92607 Ex for speech device rx, 1hr 272 0.8827 1 0.8827 1 0.8827 1 0.8827 1
92608 Ex for speech device rx addl 272 0.8827 1 0.8827 1 0.8827 1 0.8827 1
92626 Eval aud rehab status 272
92627 Eval aud status rehab add-on 272
92640 Aud brainstem implt programg 272
95951 EEG monitoring/videorecord 210
96040 Genetic counseling, 30 min 490
96101 Psycho testing by psych/phys 310 1.6551 1 1.6551 1 1.6551 1 1.6551 1
96102 Psycho testing by technician 310 1.2413 1 1.2413 1 1.2413 1 1.2413 1
96111 Developmental test, extend 310 1.2413 1 1.2413 1 1.2413 1 1.2413 1
96116 Neurobehavioral status exam 310 1.6551 1 1.6551 1 1.6551 1 1.6551 1
96118 Neuropsych tst by psych/phys 310 1.6551 1 1.6551 1 1.6551 1 1.6551 1
96119 Neuropsych testing by tec 310 1.2413 1 1.2413 1 1.2413 1 1.2413 1
96125 Cognitive test by hc pro 310 1.2413 1 1.2413 1 1.2413 1 1.2413 1
96150 Assess hlth/behave, init 490 0.1517 3 0.1517 3 0.1517 3 0.1517 3
96151 Assess hlth/behave, subseq 490 0.1448 3 0.1448 3 0.1448 3 0.1448 3
96152 Intervene hlth/behave, indiv 490 0.1379 3 0.1379 3 0.1379 3 0.1379 3
96153 Intervene hlth/behave, group 490 0.0690 4 0.0690 4 0.0690 4 0.0690 4
96154 Interv hlth/behav, fam w/pt 490 0.1379 4 0.1379 4 0.1379 4 0.1379 4
96155 Interv hlth/behav, fam w/o pt 490 0.1517 4 0.1517 4 0.1517 4 0.1517 4
97001 Pt evaluation 271
97002 Pt re-evaluation 271
97003 Ot evaluation 270
97004 Ot re-evaluation 270
97010 Hot or cold packs therapy 271
97012 Mechanical traction therapy 271
97014 Electric stimulation therapy 271
97016 Vasopneumatic device therapy 271
97018 Paraffin bath therapy 271
97022 Whirlpool therapy 271
97024 Diathermy eg, microwave 271
97026 Infrared therapy 271
97028 Ultraviolet therapy 271
97032 Electrical stimulation, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97033 Electric current therapy, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97034 Contrast bath therapy, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97035 Ultrasound therapy, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97036 Hydrotherapy, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97039 Physical therapy treatment 271
97110 Therapeutic exercises, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97112 Neuromuscular reeducation 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97113 Aquatic therapy/exercises 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97116 Gait training therapy 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97124 Massage therapy, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97139 Physical medicine procedure 271
97140 Manual therapy, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97530 Therapeutic activities, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97532 Cognitive skills development, 15 min 270 0.2414 3 0.2414 3 0.2414 3 0.2414 3
97533 Sensory integration, 15 min 270 0.2414 3 0.2414 3 0.2414 3 0.2414 3
97535 Self care mngment training, 15 min 270 0.2414 3 0.2414 3 0.2414 3 0.2414 3
97537 Community/work reintegration, 15 min 270 0.2414 3 0.2414 3 0.2414 3 0.2414 3
97542 Wheelchair mngment training, 15 min 270 0.2414 3 0.2414 3 0.2414 3 0.2414 3
97545 Work hardening 271
97750 Physical performance test, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97755 Assistive technology assess, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97760 Orthotic mgmt and training, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97761 Prosthetic training, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97762 C/o for orthotic/prosth use, 15 min 271 0.2276 3 0.2276 3 0.2276 3 0.2276 3
97799 Physical medicine procedure 271
97802 Medical nutrition, indiv, each 15 min 118 0.1793 2 0.1793 2 0.1793 2 0.1793 2
97803 Med nutrition, indiv, subseq, each 15 min 118 0.1793 2 0.1793 2 0.1793 2 0.1793 2
97804 Medical nutrition, group, each 30 min 118 0.3448 1 0.3448 1 0.3448 1 0.3448 1
97810 Acupunct w/o stimul 15 min 271 0.2276 3 0.2276 3 - 0 - 0
98941 Chiropractic manipulation 271
98960 Self-mgmt educ & train, 1 pt, 30 min 428 0.1379 4 0.1379 4 0.1379 4 0.1379 4
98961 Self-mgmt educ/train, 2-4 pt 429 0.0690 4 0.0690 4 0.0690 4 0.0690 4
98962 Self-mgmt educ/train, 5-8 pt 429 0.0690 4 0.0690 4 0.0690 4 0.0690 4
99002 Device Handling 490 0.7586 1 0.7586 1 0.7586 1 0.7586 1
99401 Preventive counseling, indiv 490 0.1724 1 0.1724 1 0.1724 1 0.1724 1
99402 Preventive counseling, indiv 490 0.3103 1 0.3103 1 0.3103 1 0.3103 1
99403 Preventive counseling, indiv 490 0.4482 1 0.4482 1 0.4482 1 0.4482 1
99404 Preventive counseling, indiv 490 0.5862 1 0.5862 1 0.5862 1 0.5862 1
99411 Preventive counseling, group 490 0.1379 1 0.1379 1 0.1379 1 0.1379 1
99412 Preventive counseling, group 490 0.2414 1 0.2414 1 0.2414 1 0.2414 1
D1320 Tobacco counseling 999
D9230 Analgesia 490
D9248 Sedation (non-iv) 490 0.4545 1 0.4545 1 0.4545 1
D9310 Dental consultation 350
D9920 Behavior management 350
G0108 Diab manage trn per indiv 428 0.1379 4 0.1379 4 0.1379 4 0.1379 4
G0109 Diab manage trn ind/group 429 0.0690 4 0.0690 4 0.0690 4 0.0690 4
G0270 MNT subs tx for change dx, each 15 min 118 0.1793 2 0.1793 2 0.1793 2 0.1793 2
G0271 Group MNT 2 or more 30 mins 118 0.1517 1 0.1517 1 0.1517 1 0.1517 1
G0283 Elec stim other than wound 271
H0001 Alcohol and/or drug assessment 323 0.8965 1 0.8965 1 0.8965 1 0.8965 1
H0004 Alcohol and/or drug services 315
H0006 Alcohol and/or drug services 320 0.4138 1 0.4138 1 0.4138 1 0.4138 1
H0014 Alcohol and/or drug services 426
H0023 Behavioral health outreach service 490 0.7034 1 0.7034 1 0.7034 1 - 1
H0031 MH health assess by non-md 323 0.8965 1 0.8965 1 0.8965 1 0.8965 1
H0038 Self-help/peer services per 15 min 490
H1000 Prenatal care atrisk assessm 490 0.2069 1 0.2069 1 0.2069 1 0.2069 1
H1005 Prenatal care enhanced srv pk 490 0.0690 1 0.0690 1 0.0690 1 0.0690 1
H2010 Comprehensive med svc 15 min 490 0.4138 1 0.4138 1 0.4138 1 0.4138 1
H2011 Crisis interven svc, per 15 min 321 0.2069 8 0.4000 6 0.4000 6 0.4000 6
Q3014 Telehealth facility fee 490
S9152 Speech therapy, re-eval 272
S9445 Patient education noc individ 999
S9446 Patient education noc group 999
S9484 Crisis intervention per hour 321 2.4136 1 2.4136 1 2.4136 1 2.4136 1
S9485 Crisis intervention mental h 312 5.7927 1 5.7927 1 5.7927 1 5.7927 1
T1007 Treatment Plan Development 320 0.4138 1 0.4138 1 0.4138 1 0.4138 1
T1013 Sign Lang/Oral Interpreter 490 - 0 0.0295 3 0.0295 3 0.0295 3
V2020 Vision svcs frames purchases 490 0.3567 1 0.3567 1 0.3567 1 0.3567 1
V2103 Spherocylindr 4.00d/12-2.00d 490 0.3567 1 0.3567 1 0.3567 1 0.3567 1
V2200 Lens spher bifoc plano 4.00d 490 0.3567 1 0.3567 1 0.3567 1 0.3567 1
V2203 Lens sphcyl bifocal 4.00d/.1 490 0.3567 1 0.3567 1 0.3567 1 0.3567 1
V2300 Lens sphere trifocal 4.00d 490
V2303 Lens sphcy trifocal 4.0/.12- 490
V5010 Assessment for hearing aid 257 0.0844 1 0.0844 1 0.0844 1
V5014 Hearing aid repair/modifying 257
V5020 Conformity evaluation 257 0.0422 1 0.0422 1 0.0422 1
V5160 Dispensing fee binaural 490 1.3792 1 1.3792 1 1.3792 1 1.3792 1
V5200 Cros hearing aid dispens fee 490 1.3792 1 1.3792 1 1.3792 1 1.3792 1
V5240 Dispensing fee bicros 490 1.3792 1 1.3792 1 1.3792 1 1.3792 1
V5241 Dispensing fee, monaural 490 0.9310 1 0.9310 1 0.9310 1 0.9310 1
V5362 Speech screening 272
V5364 Dysphagia screening 272

For periods not specifically shown, the weight used is the weight displayed on the prior effective date. For example, the rates effective December 1, 2008 will be used for visits prior to January 1, 2010.