|
2023 - 2 (7/6/2023)
2023 - 1 (4/1/2023)
2023 - 1 (4/1/2023)
Archived March 14, 2024 |
Fee Schedule (XLS 310KB)
Procedure Codes (PDF 3.21MB)
Policy Guidelines (PDF 851KB) |
|
2023 - 1 (4/1/2023)
Archived June 30, 2023 |
Fee Schedule (XLS 276KB) |
|
|
2022 - 2 (6/1/2022)
2022 - 1 (6/1/2022)
2021 - 2 (7/1/2021)
Archived March 7, 2023 |
Fee Schedule (XLS 272KB)
Procedure Codes (PDF 3.89MB)
Policy Guidelines (PDF 985KB) |
|
2022 - 1 (6/1/2022)
Archived December 22, 2022 |
Fee Schedule (XLS 276KB) |
|
2021 - 3 (9/1/2021)
2021 - 1 (7/1/2021)
Archived May 3, 2022 |
Fee Schedule (XLS 269KB)
Procedure Codes (PDF 212MB)
| |
2021 - 2 (7/1/2021)
Archived September 17, 2021 |
Fee Schedule (XLS 297KB) |
|
2021 - 1 (7/1/2021)
Archived July 9, 2021 |
Fee Schedule (XLS 297KB) |
|
2020 - 1 (9/1/2020)
2020 - 3 (11/1/2020)
2021 - 1 (3/10/2021)
Archived May 27, 2021 |
Fee Schedule (XLS 296KB)
Procedure Codes (PDF 2.12MB)
Policy Guidelines (PDF 296KB) |
|
2016 - 1 (8/1/2016)
Archived April 21, 2021 |
Incontinence Supply Management Program (PDF 190KB) |
|
2019 - 1 (3/01/2019)
Archived February 8, 2021 |
Policy Guidelines (PDF 714KB) |
|
2020 - 2 (11/1/2020)
Archived November 17, 2020 |
Procedure Codes (PDF 2.14KB) |
|
2020 - 1 (9/1/2020)
Archived October 29, 2020 |
Procedure Codes (PDF 2.4MB) |
|
2019 - 3 (8/1/2019) 2019 - 1 (8/1/2019)
Archived August 4, 2020 |
Fee Schedule (XLS 268KB) Procedure Codes (PDF 1.84MB) |
|
2019 - 2 (8/1/2019)
Archived September 30, 2019 |
Fee Schedule (XLS 268KB) |
|
2019 - 1 (8/1/2019)
Archived August 13, 2019 |
Fee Schedule (XLS 267KB) |
|
2018 - 2 (9/1/2018) 2018 - 3 (9/1/2018)
Archived June 26, 2019 |
Procedure Codes (PDF 2.38MB) Fee Schedule (XLS 275KB) |
|
2016 - 1 (7/01/2016)
Archived March 1, 2019 |
Policy Guidelines (PDF 549KB) |
|
2018 - 1 v.2 (4/1/2018) 2018 - 2 (4/1/2018)
Archived August 3, 2018 |
Procedure Codes (PDF 1.54MB) Fee Schedule (XLS 274KB) |
|
2018 - 1 (4/1/2018)
Archived May 16, 2018 |
Fee Schedule (XLS 271KB) |
|
2018 - 1 v.1 (4/01/2018)
Archived March 20, 2018 |
Procedure Codes (PDF 1.54MB) |
|
2017 - 1 (5/1/2017) 2017 - 1 (5/1/2017)
Archived March 16, 2018 |
Procedure Codes (PDF 1.43MB) Fee Schedule (XLS 266KB) |
|
2016 - 3 (11/4/2016) 2016 - 3 (7/1/2016)
Archived April 25, 2017 |
Procedure Codes (PDF 1.27MB) Fee Schedule (XLS 266KB) |
|
2016 - 2 (10/19/2016)
Archived November 3, 2016 |
Procedure Codes (PDF 1.14MB) |
|
2016 - 1 v.2 (7/01/2016)
Archived October 20, 2016 |
Procedure Codes (PDF 1.18MB) |
|
2016 - 2 (7/01/2016)
Archived July 7, 2016 |
Fee Schedule (PDF 413KB) |
|
2016 - 1 (7/01/2016)
Archived July 7, 2016 |
Procedure Codes (PDF 1.15MB) |
|
2016 - 1 (1/01/2016)
Archived June 30, 2016 |
Fee Schedule (XLS 265KB) |
|
2015 - 2 (10/01/2015)
Archived June 30, 2016 |
Procedure Codes (PDF 2MB) |
|
2013 - 1 (4/01/2013)
Archived June 30, 2016 |
Policy Guidelines (PDF 95KB) |
|
2015 - 1 (10/01/2015)
Archived May 25, 2016 |
Wheeled Mobility Equipment, Seating & Positioning Component Guidelines (PDF 626KB) |
|
2015 - 5 (8/01/2015)
Archived December 30, 2015 |
Fee Schedule (XLS 265KB) |
|
2015 - 1 (6/1/2015)
Archived September 22, 2015 |
Procedure Codes (PDF 1,039KB) |
|
2008 - 1 (5/8/2008)
Archived September 14, 2015 |
Prior Approval Guidelines (PDF 386KB) |
|
2015 - 4 (6/01/2015)
Archived July 17, 2015 |
Fee Schedule (XLS 265KB) |
|
2015 - 3 (1/1/2015)
Archived May 26, 2015 |
Fee Schedule (XLS 271KB) |
|
2014 - 2 (7/18/2014)
Archived May 5, 2015 |
Procedure Codes (PDF 2.4MB) |
|
2015 - 2 (1/01/2015)
Archived May 5, 2015 |
Fee Schedule (XLS 264KB) |
|
2015 - 1 (1/01/2015)
Archived March 20, 2015 |
Fee Schedule (XLS 264KB) |
|
2014 - 3 (7/15/2014)
Archived March 10, 2015 |
Fee Schedule (XLS 264KB) |
|
2014 - 2 (4/01/2014)
Archived July 21, 2014 |
Fee Schedule (XLS 265KB) |
|
2014 - 1 (4/2014)
Archived July 21, 2014 |
Procedure Codes (PDF 3.95MB) |
|
2014 - 1
Archived March 27, 2014 |
Fee Schedule (XLS 263KB) |
|
2013 - 2 (6/2013)
Archived March 27, 2014 |
Procedure Codes (PDF 4.07MB) |
|
2013 - 1
Archived December 16, 2013 |
Fee Schedule (XLS 263KB) |
|
2013 - 1 (4/2013)
Archived June 19, 2013 |
Procedure Codes (PDF 3.65MB) |
|
2012 - 1
Archived April 8, 2013 |
Fee Schedule (XLS 248KB) |
|
2009 - 2
Archived March 25, 2013 |
Policy Guidelines (PDF 549KB) |
|
2012 - 1 (4/2012)
Archived March 25, 2013 |
Procedure Codes (PDF 1.35MB) |
|
2011 - 5
Archived April 2, 2012 |
Fee Schedule (XLS 217KB) |
|
2011 - 1
Archived April 2, 2012 |
Procedure Codes (PDF 882KB) |
|
2010 - 1 (11/18/10)
Archived June 17, 2011 |
150003 Billing Guides (PDF 6.92MB) |
|
2011 - 4
Archived May 5, 2011 |
Fee Schedule (XLS 220KB) |
|
2010 - 1
Archived April 27, 2011 |
Procedure Codes (PDF 1.35MB) |
|
2010 - 1
Archived April 6, 2011 |
Fee Schedule (XLS 208KB) |
|
2010 - 1 (5/31/10)
Archived January 6, 2011 |
150002 Billing Guides (PDF 1.66MB) |
|
2009 - 3
Archived July 19, 2010 |
Billing Guidelines (PDF 930KB) |
|
2009 - 1
Archived April 1, 2010 |
Fee Schedule (XLS 282KB) |
|
2009 - 4
Archived April 1, 2010 |
Procedure Codes (PDF 15.89MB) |
|
2009 - 2
Archived December 3, 2009 |
Billing Guidelines (PDF 1.21MB) |
|
2009 - 1
Archived October 1, 2009 |
Billing Guidelines (PDF 1.37MB) |
|
2009 - 3
Archived September 1, 2009 |
Procedure Codes (PDF 10.6MB) |
|
2009 - 2
Archived August 13, 2009 |
Procedure Codes (PDF 820KB) |
|
2004 - 1
Archived August 13, 2009 |
Policy Guidelines (PDF 194KB) |
|
2009 - 1
Archived June 11, 2009
|
Procedure Codes (PDF 429KB) |
|
2008 - 3
Archived May 11, 2009 |
150001 Billing Guides (PDF 683KB) |
|
2008 - 1
Archived May 8, 2009
|
Procedure Codes (PDF 305KB) |
|
2008 - 2
Archived April 1, 2009 |
Fee Schedule (XLS 281KB) |
|
2008 - 2
Archived December 8, 2008
|
Billing Guidelines (PDF 426KB) |
|
2006 - 1
Archived August 4, 2008 |
Prior Approval Guidelines (PDF 195KB) |
|
2008 - 1
Archived July 24, 2008
|
Billing Guidelines (PDF 690KB) |
|
2008 - 1
Archived June 25, 2008 |
Fee Schedule (XLS 280KB) |
|
2007 - 1
Archived April 30, 2008
|
Procedure Codes (PDF 311KB)
Update - 1/1/2008 (PDF 39KB) |
|
2007 - 1
Archived April 30, 2008 |
Fee Schedule (XLS 271KB) |
|
2007 - 1
Archived January 18, 2008
|
Billing Guidelines (PDF 430KB) |
|
2006 - 1 (8/25/06)
Archived July 13, 2007 |
Billing Guidelines (PDF 500KB) |
|
2006 - 1 (4/06)
Archived July 6, 2006 |
Procedure Codes & Fee Schedule (PDF 1.7MB) |
|
| 2004 - 1 |
Prior Approval Guidelines (PDF 221KB) |
|
| 2004 - 1 |
Billing Guidelines (PDF 533KB) |
|
| 2005 - 1 (4/05) |
Procedure
Codes & Fee Schedule (PDF 1.46MB) |
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