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Physician Manual Archive

Below are the previous versions of the Physician Manual.

Version Manual Document Change Notes

2022-4

Archived August 10, 2022

Fee Schedule: Medicine (XLS 394KB)

 

2022-3

Archived August 2, 2022

Fee Schedule: Medicine (XLS 382KB)

 

2022-2

2022-2

2022-2

Archived June 30, 2022

Fee Schedule: Drug (XLS 207KB)

Fee Schedule: Medicine (XLS 382KB)

Fee Schedule: Radiology (XLS 154KB)

 

2022-1

2022-1

Archived June 30, 2022

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1348KB)

Procedure Codes: Radiology (PDF 940KB)

 

2022-1

2022-1

2022-1

2022-1

2022-1

Archived April 19, 2022

Fee Schedule: Anesthesia (XLS 71KB)

Fee Schedule: Drug (XLS 204KB)

Fee Schedule: Medicine (XLS 382KB)

Fee Schedule: Radiology (XLS 154KB)

Fee Schedule: Surgery (XLS 922KB)

 

2021-3

2021-1

2021-4

2021-1

Archived April 19, 2022

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1340KB)

Procedure Codes: Radiology (PDF 940KB)

Procedure Codes: Surgery (PDF 3005KB)

Procedure Codes: Anesthesia (PDF 1966KB)

 

2015 - 4 (10/15/15)

Archived March 18, 2022

Policy Guidelines (PDF 1,122KB)

 

2021-2

2021-6

2021-6

2021-3

2021-4

Archived March 11, 2022

Fee Schedule: Anesthesia (XLS 74KB)

Fee Schedule: Drug (XLS 187KB)

Fee Schedule: Medicine (XLS 378KB)

Fee Schedule: Radiology (XLS 152KB)

Fee Schedule: Surgery (XLS 920KB)

 

2021-2

Archived November 19, 2021

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1336KB)

 

2021-5

Archived September 30, 2021

Fee Schedule: Drug (XLS 203KB)

 

2021-3

2021-3

Archived September 23, 2021

Fee Schedule: Surgery (XLS 920KB)

Procedure Codes: Surgery (XLS 215KB)

 

2021-4

Archived September 7, 2021

Fee Schedule: Drug (XLS 203KB)

 

2021-5

Archived September 7, 2021

Fee Schedule: Medicine (XLS 378KB)

 

2021-3

Archived August 26, 2021

Fee Schedule: Drug (XLS 196KB)

 

2021-4

Archived August 2, 2021

Fee Schedule: Medicine (XLS 376KB)

 

2021-2

2021-2

2021-3

Archived July 1, 2021

Fee Schedule: Radiology (XLS 153KB)

Fee Schedule: Drug (XLS 195KB)

Fee Schedule: Medicine (XLS 370KB)

 

2021-1

2021-2

Archived July 1, 2021

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1333KB)

Procedure Codes: Surgery (PDF 2152KB)

 

2021-1

Archived June 9, 2021

Procedure Codes: Surgery (PDF 3005KB)

 

2021-1

2021-1

2021-2

2021-1

2021-2

Archived April 27, 2021

Fee Schedule: Anesthesia (XLS 74KB)

Fee Schedule: Drug (XLS 187KB)

Fee Schedule: Medicine (XLS 370KB)

Fee Schedule: Radiology (XLS 152KB)

Fee Schedule: Surgery (XLS 919KB)

 

2020-2

2020-1

2020-1

2020-1

Archived April 27, 2021

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1995KB)

Procedure Codes: Radiology (PDF 1040KB)

Procedure Codes: Surgery (PDF 3005KB)

Procedure Codes: Anesthesia (PDF 833KB)

 

2021-1

2021-1

Archived January 8, 2021

Fee Schedule: Medicine (XLS 369KB)

Fee Schedule: Surgery (XLS 919KB)

 

2020-1

2020-5

2020-6

2020-3

2020-3

Archived January 4, 2021

Fee Schedule: Anesthesia (XLS 74KB)

Fee Schedule: Drug (XLS 187KB)

Fee Schedule: Medicine (XLS 370KB)

Fee Schedule: Radiology (XLS 156KB)

Fee Schedule: Surgery (XLS 919KB)

 

2020-4

2020-1

Archived September 4, 2020

Fee Schedule: Drug and Drug Administration (XLS 187KB)

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1058KB)

 

2019-2

2019-1

2019-1

2019-1

Archived August 17, 2020

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1995KB)

Procedure Codes: Radiology (PDF 1040KB)

Procedure Codes: Surgery (PDF 3005KB)

Procedure Codes: Anesthesia (PDF 833KB)

 

2020-5

2020-3

2020-2

2020-2

Archived August 17, 2020

Fee Schedule: Medicine (XLS 370KB)

Fee Schedule: Drug and Drug Administration (XLS 191KB)

Fee Schedule: Radiology (XLS 156KB)

Fee Schedule: Surgery (XLS 919KB)

 

2020-2

Archived June 5, 2020

Fee Schedule: Drugs (XLS 190KB)

 

2020-4

Archived May 20, 2020

Fee Schedule: Medicine (XLS 370KB)

 

2020-3

Archived April 30, 2020

Fee Schedule: Medicine (XLS 373KB)

 

2020-1

Archived April 30, 2020

Fee Schedule: Drugs (XLS 181KB)

 

2020-1

Archived April 30, 2020

Fee Schedule: Radiology (XLS 155KB)

 

2020-1

Archived April 30, 2020

Fee Schedule: Surgery (XLS 923KB)

 

2019-1

Archived April 30, 2020

Fee Schedule: Anesthesia (XLS 74KB)

 

2020-2

Archived April 13, 2020

Fee Schedule: Medicine (XLS 370KB)

 

2020-1

Archived March 24, 2020

Fee Schedule: Medicine (XLS 371KB)

 

2019-1

2019-2

2019-2

2019-3

Archived January 13, 2020

Fee Schedule: Medicine (XLS 355KB)

Fee Schedule: Drug and Drug Administration (XLS 181KB)

Fee Schedule: Radiology (XLS 150KB)

Fee Schedule: Surgery (XLS 914KB)

 

2019-1

Archived December 18, 2019

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1154KB)

 

2019-2 (04/01/19)

Archived August 28, 2019

Fee Schedule: Surgery (XLS 913KB)

 

2018-1

2018-1

2018-1

2018-1

Archived March 22, 2019

Procedure Codes: Medicine, Drugs, and Drug Administration (PDF 1264KB)

Procedure Codes: Radiology (PDF 649KB)

Procedure Codes: Surgery (PDF 1111KB)

Procedure Codes: Anesthesia (PDF 512KB)

 

2019-1 (01/01/19)

2019-1 (01/01/19)

2019-1 (01/01/19)

Archived March 22, 2019

Fee Schedule: Drug & Drug Administration (XLS 177KB)

Fee Schedule: Radiology (XLS 149KB)

Fee Schedule: Surgery (XLS 913KB)

 

2018-2 (04/01/18)

2018-2 (04/01/18)

2018-1 (01/01/18)

2018-2 (04/01/18)

2018-1 (01/01/18)

Archived December 27, 2018

Fee Schedule: Medicine (XLS 124KB)

Fee Schedule: Drug & Drug Administration (XLS 176KB)

Fee Schedule: Radiology (XLS 150KB)

Fee Schedule: Surgery (XLS 912KB)

Fee Schedule: Anesthesia (XLS 74KB)

 

2017-1

Archived March 30, 2018

Procedure Codes: Medicine and Drugs (PDF 512KB)

 

2018-1 (01/01/18)

2018-1 (01/01/18)

2018-1 (01/01/18)

Archived March 30, 2018

Fee Schedule: Medicine (XLS 124KB)

Fee Schedule: Drug & Drug Administration (XLS 174KB)

Fee Schedule: Surgery (XLS 911KB)

 

2017-1

2017-1

2017-1

Archived March 27, 2018

Procedure Codes: Radiology (PDF 206KB)

Procedure Codes: Surgery (PDF 1.08MB)

Procedure Codes: Anesthesia (PDF 99KB)

 

2017-2 (04/01/17)

2017-2 (04/01/17)

2017-2 (04/01/17)

2017-2 (04/01/17)

2017-1 (01/01/17)

Archived December 27, 2017

Fee Schedule: Medicine (XLS 122KB)

Fee Schedule: Drug & Drug Administration (XLS 177KB)

Fee Schedule: Radiology (XLS 151KB)

Fee Schedule: Surgery (XLS 909KB)

Fee Schedule: Anesthesia (XLS 62KB)

 

2017-1 (04/01/10)

Archived July 21, 2017

Enhanced Program Fee Schedule: Physician Section 6 (XLS 22KB)

 

2017-1 (01/01/17)

2017-1 (01/01/17)

2017-1 (01/01/17)

2017-1 (01/01/17)

Archived March 24, 2017

Fee Schedule: Medicine (XLS 121KB)

Fee Schedule: Drug & Drug Administration (XLS 175KB)

Fee Schedule: Radiology (XLS 150KB)

Fee Schedule: Surgery (XLS 909KB)

 

2015-1 (10/15/15)

2016-1

2016-1

2016-2

2016-1

Archived March 23, 2017

Procedure Codes: General Information (PDF 80KB)

Procedure Codes: Medicine and Drugs (PDF 521KB)

Procedure Codes: Radiology (PDF 216KB)

Procedure Codes: Surgery (PDF 1.28MB)

Procedure Codes: Anesthesia (PDF 101KB)

 

2016-2 (04/01/16)

2016-2 (04/01/16)

2016-2 (04/01/16)

2016-1 (01/01/16)

2016-1 (01/01/16)

Archived December 29, 2016

Fee Schedule: Medicine (XLS 115KB)

Fee Schedule: Drug & Drug Administration (XLS 169KB)

Fee Schedule: Surgery (XLS 903KB)

Fee Schedule: Anesthesia (XLS 62KB)

Fee Schedule: Radiology (XLS 57KB)

 

2016-1 (03/30/16)

Archived April 27, 2016

Procedure Codes: Surgery (PDF 1.13MB)

 

2016-1 (01/01/16)

2016-1 (01/01/16)

2016-1 (01/01/16)

Archived March 30, 2016

Fee Schedule: Medicine (XLS 119KB)

Fee Schedule: Drug & Drug Administration (XLS 169KB)

Fee Schedule: Surgery (XLS 800KB)

 

2015-2 (05/05/15)

2015-2 (05/05/15)

2015-2 (05/05/15)

2015-2 (05/05/15)

Archived March 30, 2016

Procedure Codes: Medicine and Drugs (PDF 454KB)

Procedure Codes: Radiology (PDF 193KB)

Procedure Codes: Surgery (PDF 1.05MB)

Procedure Codes: Anesthesia (PDF 104KB)

 

2015 - 1 (01/01/15)

2015 - 2 (04/01/15)

2015 - 2 (04/01/15)

2015 - 2 (04/01/15)

2015 - 2 (04/01/15)

Archived December 29, 2015

Fee Schedule Anesthesia (XLS 57KB)

Fee Schedule Drug & Drug Administration (XLS 51KB)

Fee Schedule Medicine (XLS 49KB)

Fee Schedule Radiology (XLS 137KB)

Fee Schedule Surgery (XLS 312KB)

 

2008 - 1 (05/15/08)

2015 - 3 (08/07/15)


Archived October 15, 2015

Procedure Codes - General Information (PDF 41KB)

Policy Guidelines (PDF 308KB)

 

2008 - 2 (04/15/08)

Archived September 14, 2015

Policy Guidelines (PDF 339KB)

 

2008 - 1 (05/08/08)

Archived September 14, 2015

Prior Approval Guidelines (PDF 282KB)

 

2015 - 1 (01/01/15)

Archived May 5, 2015

Fee Schedules Surgery (XLS 785KB)

 

2015 - 1 (01/01/15)

Archived May 5, 2015

Fee Schedules Radiology (XLS 137KB)

 

2015 - 1 (01/01/15)

Archived May 5, 2015

Fee Schedules Drugs (XLS 115KB)

 

2015 - 1 (01/01/15)

Archived May 5, 2015

Fee Schedules Medicine (XLS 114KB)

 

2015 - 1 (04/01/14)

Archived May 5, 2015

Procedure Codes Medicine and Drugs (PDF 667KB)

 

2015 - 1 (04/01/14)

Archived May 5, 2015

Procedure Codes Radiology (PDF 294KB)

 

2015 - 1 (04/01/14)

Archived May 5, 2015

Procedure Codes Surgery (PDF 1,724KB)

 

2015 - 1 (04/01/11)

Archived May 5, 2015

Procedure Codes Anesthesia (PDF 96KB)

 

2014 - 2 (04/01/14)

Archived March 10, 2015

Fee Schedules Radiology (XLS 148KB)

 

2014 - 3 (09/01/14)

Archived December 31, 2014

Fee Schedules Medicine (XLS 125KB)

 

2014 - 2 (04/01/14)

Archived December 31, 2014

Fee Schedules Drugs and Drug Administration (XLS 175KB)

 

2014 - 2 (04/01/14)

Archived December 31, 2014

Fee Schedules Surgery (XLS 825KB)

 

2010 - 1 (11/18/10)

Archived December 31, 2014

Fee Schedules Anesthesia (XLS 71KB)

 

2014 - 2 (04/01/14)

Archived August 29, 2014

Fee Schedules Medicine (XLS 130KB)

 

2013 - 2 (01/01/13)

Archived May 23, 2014

Primary Care Rate Increase Fee Schedule (XLSX 38KB)

 

2014 - 1 (04/01/14)

Archived May 12, 2014

Procedure Codes: Medicine and Drugs (PDF 645KB)  

2014 - 1 (01/01/14)

Archived April 4, 2014

Fee Schedules:

Fee Schedules Drugs (XLS 173KB)
Fee Schedules Medicine (XLS 130KB)
Fee Schedules Radiology (XLS 148KB)
Fee Schedules Surgery (XLS 791KB)

 

2013 - 2 (04/01/13)

Archived April 4, 2014

Procedure Codes:

Procedure Codes Medicine and Drugs (PDF 688KB)
Procedure Codes Radiology (PDF 266KB)
Procedure Codes Surgery (PDF 1763KB)

 

2013 - 3 (4/01/13)

Archived January 2, 2014

Fee Schedules:

Fee Schedules Drugs (XLS 173KB)
Fee Schedules Medicine (XLS 128KB)
Fee Schedules Radiology (XLS 148KB)
Fee Schedules Surgery (XLS 786KB)

 

2013 - 4 (05/01/13)

Archived October 8, 2013

Primary Care Rate Increase FAQs (PDF 169KB)

 

2013 - 1 (01/01/13)

Archived June 26, 2013

Primary Care Rate Increase Fee Schedule (XLSX 34KB)

Added a tab with a key for the regions.

2013 - 2 (1/01/13)

Archived April 9, 2013

Fee Schedules:

Fee Schedules Drugs (XLS 163KB)
Fee Schedules Medicine (XLS 138KB)
Fee Schedules Radiology (XLS 147KB)
Fee Schedules Surgery (XLS 836KB)

 

2013 - 1 (1/01/13)


Archived April 9, 2013

Procedure Codes:

Procedure Codes Medicine and Drugs (PDF 644KB)
Procedure Codes Radiology (PDF 264KB)
Procedure Codes Surgery (PDF 1.75MB)
 

2012 - 2 (04/01/12)

Archived January 2, 2013

Fee Schedules:

Fee Schedules Drugs (XLS 119KB)
Fee Schedules Medicine (XLS 130KB)
Fee Schedules Radiology (XLS 151KB)
Fee Schedules Surgery (XLS 885KB)

 

2011 - 1 (4/01/11)


Archived April 4, 2012

Procedure Codes:

Procedure Codes Medicine and Drugs (PDF 657KB)
Procedure Codes Radiology (PDF 275KB)
Procedure Codes Surgery (PDF 1.71MB)
 

2012 - 1 (01/01/12)

Archived April 4, 2012

Fee Schedules:

Fee Schedules Drugs (XLS 128KB)
Fee Schedules Medicine (XLS 117KB)
Fee Schedules Radiology (XLS 150KB)
Fee Schedules Surgery (XLS 877KB)

 

2011 - 2 (04/01/11)

Archived December 29, 2011

Fee Schedules:

Fee Schedules Drugs (XLS 114KB)
Fee Schedules Medicine (XLS 124KB)
Fee Schedules Surgery (XLS 879KB)

 

2011 - 3 (07/01/11)

Archived December 29, 2011

Fee Schedules Radiology (XLS 149KB)

 

2011 - 2 (04/01/11)

Archived June 30, 2011

Fee Schedules Radiology (XLS 143KB)

 

2010 - 2 (12/23/10)

Archived June 20, 2011

150003 Billing Guidelines (PDF 6.46MB)  

2010 - 1 (4/01/10)


Archived April 4, 2011

Procedure Codes:

Procedure Codes Radiology (PDF 336KB)
Procedure Codes Surgery (PDF 2.15MB)
 

2011 - 1 (01/01/11)

 

Archived April 4, 2011

Fee Schedules:

Fee Schedules Radiology (XLS 136KB)
Fee Schedules Surgery (XLS 874KB)

 

2011 - 1 (01/01/11)

Archived April 1, 2011

Fee Schedules:

Fee Schedules Medicine (XLS 122KB)
Fee Schedules Drugs (XLS 111KB)


 

2010 - 1 (11/18/10)

Archived April 1, 2011

Procedure Codes Anesthesia (PDF 111KB)


 

2010 - 1 (04/01/10)

Archived April 1, 2011

Procedure Codes Medicine and Drugs (PDF 973KB)

 

2010 - 1 (11/18/10)

Archived January 12, 2011

150003 Billing Guidelines (PDF 6.09MB)  

2010 - 2 (10/01/10)

Archived January 5, 2011

Fee Schedules Drugs (XLS 112KB)

 

2010 - 1 (4/01/10)

Archived January 5, 2011

Fee Schedules:

Fee Schedules Medicine (XLS 132KB)
Fee Schedules Radiology (XLS 142KB)
Fee Schedules Surgery (XLS 951KB)

 

2010 - 02 (07/01/10)

Archived November 17, 2010

150002 Billing Guidelines (PDF 1.98MB)  

2010 - 1 (4/01/10)

Archived September 30, 2010

Fee Schedules Drugs (XLS 109KB)

 

2010 - 01 (05/31/10)

Archived July 29, 2010

150002 Billing Guidelines (PDF 2.34MB)  

2009 - 3 (12/01/09)

Archived July 19, 2010

150002 Billing Guidelines (PDF 852KB)  

2009 - 1 (4/01/09)

Archived April 1, 2010

Fee Schedules:

Fee Schedules Medicine (XLS 130k)
Fee Schedules Drugs (XLS 260k)
Fee Schedules Radiology (XLS 155k)
Fee Schedules Surgery (XLS 1.02MB)

 

2009 - 1 (4/01/09)

Archived April 1, 2010

Procedure Codes:

Procedure Codes Medicine (PDF 294k)
Procedure Codes Drugs (PDF 148k)
Procedure Codes Radiology (PDF 242k)
Procedure Codes Surgery (PDF 853k)

 

2009 - 2 (10/01/09)

Archived December 3, 2009

150002 Billing Guidelines (PDF 1.48MB)  

2009 - 1 (1/29/08)

Archived September 23, 2009

150002 Billing Guidelines (PDF 1.30MB)  

2009 - 1 (1/02/09)

Archived May 7, 2009

150001 Billing Guidelines (PDF 441KB)  

2008 - 1 (5/15/08)

Archived April 1, 2009

Procedure Codes:

Procedure Codes Medicine (PDF 413k)
Procedure Codes Drugs (PDF 71k)
Procedure Codes Radiology (PDF 140k)
Procedure Codes Surgery (PDF 764k)

 

2009 - 1 (12/22/08)

Archived April 1, 2009

Fee Schedules:

Fee Schedules Medicine (XLS 118k)
Fee Schedules Drugs (XLS 101k)
Fee Schedules Surgery (XLS 933k)

 

2008 - 4 (11/11/08)

Archived January 05, 2009

Billing Guidelines (PDF 1.03MB)  

2009 - 1 (12/08)

Archived December 11, 2008

Fee Schedules Radiology (XLS 187k)

 

2008 - 3 (6/4/08)

Archived December 4, 2008

Billing Guidelines (PDF 465KB)  

2008 - 1 (5/21/08)

Archived November 25, 2008

Fee Schedules:

Fee Schedules Medicine (XLS 99k)
Fee Schedules Drugs (XLS 89k)
Fee Schedules Radiology (XLS 116k)
Fee Schedules Surgery (XLS 740k)

 

2006 - 1 (11/21/06)

Archived August 4, 2008

Prior Approval Guidelines (PDF 124KB)  

2008 - 2 (1/30/08)

Archived July 24, 2008

Billing Guidelines (PDF 462KB)  

2006 - 1 (4/06)

Archived May 21, 2008

Procedure Codes & Fee Schedule (PDF 1.3MB)  

2008 - 1 (2/15)

Archived May 14, 2008

Policy Guidelines (PDF 338KB)  

2004 - 1 (1/05)

Archived February 29, 2008

Policy Guidelines (PDF 617KB)  

2008 - 1 (1/16)

Archived February 6, 2008

Billing Guidelines (PDF 463KB)  

2007 - 1 (5/07)

Archived January 18, 2008

Billing Guidelines (PDF 491KB)  

2007 - 1

Archived October 5, 2007

Procedure Codes & Fee Schedule Update (PDF 17KB)  

2006 - 1 (5/06)

Archived July 11, 2007

Billing Guidelines (PDF 537KB)  
2004 - 1 Prior Approval Guidelines (PDF 150KB)  
2005 - 1 Billing Guidelines (PDF 560KB)  
2005 - 1 (4/05) Procedure Codes & Fee Schedule (PDF 1.3MB)  
033-10:17:01 AM