{ "reporting_entity_name": "WPS", "reporting_entity_type": "health insurance issuer", "last_updated_on": "2026-06-17 12:20:57.546632", "provider_references": [ { "provider_group_id": 1, "network_name": [ "Indemnity-Standard" ], "provider_groups": [ { "npi": [ "1710013628", "1114422375", "1376631077", "1932102977", "1457794794", "1265744973", "1538309877", "1780252643", "1578954731", "1982193702", "1265798656", "1417105420", "1619963568", "1265961056", "1043383441", "1245403567", "1770579096", "1265710586" ], "tin": { "type": "ein", "value": "201020949", "business_name": "TELADOC PA" } } ] }, { "provider_group_id": 2, "network_name": [ "Indemnity-Standard" ], "provider_groups": [ { "npi": [ "1154963841", "1821438268" ], "tin": { "type": "ein", "value": "832193832", "business_name": "CATAPULT HEALTH PA" } } ] }, { "provider_group_id": 3, "network_name": [ "Indemnity-Standard" ], "provider_groups": [ { "npi": [ "1699146456" ], "tin": { "type": "ein", "value": "474591265", "business_name": "TELADOCPA BEHAVIORAL HEALTH" } } ] } ], "in_network": [ { "name": "Ambulance service, outside state per mile, transport (medicaid only)", "description": "Ambulance service, outside state per mile, transport (medicaid only)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest", "description": "Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest", "description": "Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation; taxi", "description": "Non-emergency transportation; taxi", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation and bus, intra or inter state carrier", "description": "Non-emergency transportation and bus, intra or inter state carrier", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems", "description": "Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation: wheelchair van", "description": "Non-emergency transportation: wheelchair van", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation and air travel (private or commercial) intra or inter state", "description": "Non-emergency transportation and air travel (private or commercial) intra or inter state", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation: per mile - case worker or social worker", "description": "Non-emergency transportation: per mile - case worker or social worker", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transportation ancillary: parking fees, tolls, other", "description": "Transportation ancillary: parking fees, tolls, other", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation: ancillary: lodging-recipient", "description": "Non-emergency transportation: ancillary: lodging-recipient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation: ancillary: meals-recipient", "description": "Non-emergency transportation: ancillary: meals-recipient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation: ancillary: lodging escort", "description": "Non-emergency transportation: ancillary: lodging escort", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation: ancillary: meals-escort", "description": "Non-emergency transportation: ancillary: meals-escort", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, neonatal transport, base rate, emergency transport, one way", "description": "Ambulance service, neonatal transport, base rate, emergency transport, one way", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bls mileage (per mile)", "description": "Bls mileage (per mile)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bls routine disposable supplies", "description": "Bls routine disposable supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0382", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bls specialized service disposable supplies; defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances)", "description": "Bls specialized service disposable supplies; defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0384", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Als mileage (per mile)", "description": "Als mileage (per mile)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Als specialized service disposable supplies; defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances)", "description": "Als specialized service disposable supplies; defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0392", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Als specialized service disposable supplies; iv drug therapy", "description": "Als specialized service disposable supplies; iv drug therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0394", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Als specialized service disposable supplies; esophageal intubation", "description": "Als specialized service disposable supplies; esophageal intubation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0396", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Als routine disposable supplies", "description": "Als routine disposable supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0398", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance waiting time (als or bls), one half (1/2) hour increments", "description": "Ambulance waiting time (als or bls), one half (1/2) hour increments", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation", "description": "Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0422", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)", "description": "Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0424", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ground mileage, per statute mile", "description": "Ground mileage, per statute mile", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0425", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)", "description": "Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0426", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)", "description": "Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0427", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, basic life support, non-emergency transport, (bls)", "description": "Ambulance service, basic life support, non-emergency transport, (bls)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0428", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, basic life support, emergency transport (bls-emergency)", "description": "Ambulance service, basic life support, emergency transport (bls-emergency)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0429", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, conventional air services, transport, one way (fixed wing)", "description": "Ambulance service, conventional air services, transport, one way (fixed wing)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, conventional air services, transport, one way (rotary wing)", "description": "Ambulance service, conventional air services, transport, one way (rotary wing)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0431", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers", "description": "Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0432", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Advanced life support, level 2 (als 2)", "description": "Advanced life support, level 2 (als 2)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0433", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty care transport (sct)", "description": "Specialty care transport (sct)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0434", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fixed wing air mileage, per statute mile", "description": "Fixed wing air mileage, per statute mile", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0435", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rotary wing air mileage, per statute mile", "description": "Rotary wing air mileage, per statute mile", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0436", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility)", "description": "Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0888", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance response and treatment, no transport", "description": "Ambulance response and treatment, no transport", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0998", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unlisted ambulance service", "description": "Unlisted ambulance service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Syringe with needle, sterile, 1 cc or less, each", "description": "Syringe with needle, sterile, 1 cc or less, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Syringe with needle, sterile 2 cc, each", "description": "Syringe with needle, sterile 2 cc, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Syringe with needle, sterile 3 cc, each", "description": "Syringe with needle, sterile 3 cc, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Syringe with needle, sterile 5 cc or greater, each", "description": "Syringe with needle, sterile 5 cc or greater, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Needle-free injection device, each", "description": "Needle-free injection device, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supplies for self-administered injections", "description": "Supplies for self-administered injections", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-coring needle or stylet with or without catheter", "description": "Non-coring needle or stylet with or without catheter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Syringe, sterile, 20 cc or greater, each", "description": "Syringe, sterile, 20 cc or greater, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Needle, sterile, any size, each", "description": "Needle, sterile, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sterile water, saline and/or dextrose, diluent/flush, 10 ml", "description": "Sterile water, saline and/or dextrose, diluent/flush, 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sterile water/saline, 500 ml", "description": "Sterile water/saline, 500 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4217", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sterile saline or water, metered dose dispenser, 10 ml", "description": "Sterile saline or water, metered dose dispenser, 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4218", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Refill kit for implantable infusion pump", "description": "Refill kit for implantable infusion pump", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)", "description": "Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)", "description": "Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)", "description": "Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4223", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supplies for maintenance of insulin infusion catheter, per week", "description": "Supplies for maintenance of insulin infusion catheter, per week", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4224", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supplies for external insulin infusion pump, syringe type cartridge, sterile, each", "description": "Supplies for external insulin infusion pump, syringe type cartridge, sterile, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week", "description": "Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4226", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion set for external insulin pump, non needle cannula type", "description": "Infusion set for external insulin pump, non needle cannula type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion set for external insulin pump, needle type", "description": "Infusion set for external insulin pump, needle type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4231", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Syringe with needle for external insulin pump, sterile, 3 cc", "description": "Syringe with needle for external insulin pump, sterile, 3 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4232", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each", "description": "Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4233", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each", "description": "Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4234", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each", "description": "Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4235", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each", "description": "Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4236", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol or peroxide, per pint", "description": "Alcohol or peroxide, per pint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4244", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol wipes, per box", "description": "Alcohol wipes, per box", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Betadine or phisohex solution, per pint", "description": "Betadine or phisohex solution, per pint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Betadine or iodine swabs/wipes, per box", "description": "Betadine or iodine swabs/wipes, per box", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chlorhexidine containing antiseptic, 1 ml", "description": "Chlorhexidine containing antiseptic, 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urine test or reagent strips or tablets (100 tablets or strips)", "description": "Urine test or reagent strips or tablets (100 tablets or strips)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood ketone test or reagent strip, each", "description": "Blood ketone test or reagent strip, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4252", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips", "description": "Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4253", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platforms for home blood glucose monitor, 50 per box", "description": "Platforms for home blood glucose monitor, 50 per box", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Normal, low and high calibrator solution / chips", "description": "Normal, low and high calibrator solution / chips", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4256", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement lens shield cartridge for use with laser skin piercing device, each", "description": "Replacement lens shield cartridge for use with laser skin piercing device, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spring-powered device for lancet, each", "description": "Spring-powered device for lancet, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4258", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lancets, per box of 100", "description": "Lancets, per box of 100", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4259", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical cap for contraceptive use", "description": "Cervical cap for contraceptive use", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4261", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Temporary, absorbable lacrimal duct implant, each", "description": "Temporary, absorbable lacrimal duct implant, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4262", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Permanent, long term, non-dissolvable lacrimal duct implant, each", "description": "Permanent, long term, non-dissolvable lacrimal duct implant, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4263", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Permanent implantable contraceptive intratubal occlusion device(s) and delivery system", "description": "Permanent implantable contraceptive intratubal occlusion device(s) and delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4264", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Paraffin, per pound", "description": "Paraffin, per pound", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diaphragm for contraceptive use", "description": "Diaphragm for contraceptive use", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4266", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contraceptive supply, condom, male, each", "description": "Contraceptive supply, condom, male, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4267", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contraceptive supply, condom, female, each", "description": "Contraceptive supply, condom, female, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4268", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contraceptive supply, spermicide (e.g., foam, gel), each", "description": "Contraceptive supply, spermicide (e.g., foam, gel), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4269", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable endoscope sheath, each", "description": "Disposable endoscope sheath, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adhesive skin support attachment for use with external breast prosthesis, each", "description": "Adhesive skin support attachment for use with external breast prosthesis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tubing for breast pump, replacement", "description": "Tubing for breast pump, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4281", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adapter for breast pump, replacement", "description": "Adapter for breast pump, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4282", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cap for breast pump bottle, replacement", "description": "Cap for breast pump bottle, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4283", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast shield and splash protector for use with breast pump, replacement", "description": "Breast shield and splash protector for use with breast pump, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4284", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Polycarbonate bottle for use with breast pump, replacement", "description": "Polycarbonate bottle for use with breast pump, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Locking ring for breast pump, replacement", "description": "Locking ring for breast pump, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4286", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sacral nerve stimulation test lead, each", "description": "Sacral nerve stimulation test lead, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access", "description": "Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)", "description": "Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable drug delivery system, flow rate of 50 ml or greater per hour", "description": "Disposable drug delivery system, flow rate of 50 ml or greater per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4305", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable drug delivery system, flow rate of less than 50 ml per hour", "description": "Disposable drug delivery system, flow rate of less than 50 ml per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4306", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion tray without drainage bag and without catheter (accessories only)", "description": "Insertion tray without drainage bag and without catheter (accessories only)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)", "description": "Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4311", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone", "description": "Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4312", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation", "description": "Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4313", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)", "description": "Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4314", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone", "description": "Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation", "description": "Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4316", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Irrigation tray with bulb or piston syringe, any purpose", "description": "Irrigation tray with bulb or piston syringe, any purpose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic agent for urinary catheter irrigation", "description": "Therapeutic agent for urinary catheter irrigation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4321", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Irrigation syringe, bulb or piston, each", "description": "Irrigation syringe, bulb or piston, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4322", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Male external catheter with integral collection chamber, any type, each", "description": "Male external catheter with integral collection chamber, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4326", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Female external urinary collection device; meatal cup, each", "description": "Female external urinary collection device; meatal cup, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4327", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Female external urinary collection device; pouch, each", "description": "Female external urinary collection device; pouch, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4328", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Perianal fecal collection pouch with adhesive, each", "description": "Perianal fecal collection pouch with adhesive, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each", "description": "Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4331", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lubricant, individual sterile packet, each", "description": "Lubricant, individual sterile packet, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4332", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urinary catheter anchoring device, adhesive skin attachment, each", "description": "Urinary catheter anchoring device, adhesive skin attachment, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4333", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urinary catheter anchoring device, leg strap, each", "description": "Urinary catheter anchoring device, leg strap, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4334", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence supply; miscellaneous", "description": "Incontinence supply; miscellaneous", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4335", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence supply, urethral insert, any type, each", "description": "Incontinence supply, urethral insert, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4336", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence supply, rectal insert, any type, each", "description": "Incontinence supply, rectal insert, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4337", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each", "description": "Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4338", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each", "description": "Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indwelling catheter, foley type, two-way, all silicone, each", "description": "Indwelling catheter, foley type, two-way, all silicone, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4344", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indwelling catheter; foley type, three way for continuous irrigation, each", "description": "Indwelling catheter; foley type, three way for continuous irrigation, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4346", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Male external catheter, with or without adhesive, disposable, each", "description": "Male external catheter, with or without adhesive, disposable, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4349", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each", "description": "Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4351", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each", "description": "Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4352", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intermittent urinary catheter, with insertion supplies", "description": "Intermittent urinary catheter, with insertion supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4353", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion tray with drainage bag but without catheter", "description": "Insertion tray with drainage bag but without catheter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4354", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each", "description": "Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4355", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External urethral clamp or compression device (not to be used for catheter clamp), each", "description": "External urethral clamp or compression device (not to be used for catheter clamp), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4356", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each", "description": "Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4357", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each", "description": "Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4358", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable external urethral clamp or compression device, with pad and/or pouch, each", "description": "Disposable external urethral clamp or compression device, with pad and/or pouch, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy faceplate, each", "description": "Ostomy faceplate, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4361", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin barrier; solid, 4 x 4 or equivalent; each", "description": "Skin barrier; solid, 4 x 4 or equivalent; each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4362", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy clamp, any type, replacement only, each", "description": "Ostomy clamp, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4363", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adhesive, liquid or equal, any type, per oz", "description": "Adhesive, liquid or equal, any type, per oz", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy vent, any type, each", "description": "Ostomy vent, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4366", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy belt, each", "description": "Ostomy belt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4367", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy filter, any type, each", "description": "Ostomy filter, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4368", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, liquid (spray, brush, etc.), per oz", "description": "Ostomy skin barrier, liquid (spray, brush, etc.), per oz", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4369", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, powder, per oz", "description": "Ostomy skin barrier, powder, per oz", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4371", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each", "description": "Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4372", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each", "description": "Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4373", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, with faceplate attached, plastic, each", "description": "Ostomy pouch, drainable, with faceplate attached, plastic, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4375", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, with faceplate attached, rubber, each", "description": "Ostomy pouch, drainable, with faceplate attached, rubber, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4376", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, for use on faceplate, plastic, each", "description": "Ostomy pouch, drainable, for use on faceplate, plastic, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4377", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, for use on faceplate, rubber, each", "description": "Ostomy pouch, drainable, for use on faceplate, rubber, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4378", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, with faceplate attached, plastic, each", "description": "Ostomy pouch, urinary, with faceplate attached, plastic, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4379", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, with faceplate attached, rubber, each", "description": "Ostomy pouch, urinary, with faceplate attached, rubber, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, for use on faceplate, plastic, each", "description": "Ostomy pouch, urinary, for use on faceplate, plastic, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4381", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, for use on faceplate, heavy plastic, each", "description": "Ostomy pouch, urinary, for use on faceplate, heavy plastic, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4382", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, for use on faceplate, rubber, each", "description": "Ostomy pouch, urinary, for use on faceplate, rubber, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4383", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy faceplate equivalent, silicone ring, each", "description": "Ostomy faceplate equivalent, silicone ring, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4384", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each", "description": "Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4385", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each", "description": "Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4387", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each", "description": "Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4388", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each", "description": "Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4389", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each", "description": "Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each", "description": "Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4391", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each", "description": "Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4392", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each", "description": "Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4393", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce", "description": "Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4394", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy deodorant for use in ostomy pouch, solid, per tablet", "description": "Ostomy deodorant for use in ostomy pouch, solid, per tablet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4395", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy belt with peristomal hernia support", "description": "Ostomy belt with peristomal hernia support", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4396", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Irrigation supply; sleeve, each", "description": "Irrigation supply; sleeve, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4397", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy irrigation supply; bag, each", "description": "Ostomy irrigation supply; bag, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4398", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy irrigation supply; cone/catheter, with or without brush", "description": "Ostomy irrigation supply; cone/catheter, with or without brush", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4399", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy irrigation set", "description": "Ostomy irrigation set", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lubricant, per ounce", "description": "Lubricant, per ounce", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4402", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy ring, each", "description": "Ostomy ring, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4404", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, non-pectin based, paste, per ounce", "description": "Ostomy skin barrier, non-pectin based, paste, per ounce", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4405", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, pectin-based, paste, per ounce", "description": "Ostomy skin barrier, pectin-based, paste, per ounce", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4406", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each", "description": "Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4407", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each", "description": "Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4408", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each", "description": "Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4409", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each", "description": "Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each", "description": "Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4411", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each", "description": "Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4412", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each", "description": "Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4413", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each", "description": "Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4414", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each", "description": "Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4415", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed, with barrier attached, with filter (1 piece), each", "description": "Ostomy pouch, closed, with barrier attached, with filter (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4416", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each", "description": "Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4417", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed; without barrier attached, with filter (1 piece), each", "description": "Ostomy pouch, closed; without barrier attached, with filter (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4418", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each", "description": "Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4419", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each", "description": "Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy supply; miscellaneous", "description": "Ostomy supply; miscellaneous", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4421", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each", "description": "Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4422", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each", "description": "Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4423", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each", "description": "Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4424", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each", "description": "Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4425", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each", "description": "Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4426", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each", "description": "Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4427", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each", "description": "Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4428", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each", "description": "Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4429", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each", "description": "Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each", "description": "Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4431", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each", "description": "Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4432", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each", "description": "Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4433", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each", "description": "Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4434", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each", "description": "Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4435", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tape, non-waterproof, per 18 square inches", "description": "Tape, non-waterproof, per 18 square inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tape, waterproof, per 18 square inches", "description": "Tape, waterproof, per 18 square inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rectal catheter for use with the manual pump-operated enema system, replacement only", "description": "Rectal catheter for use with the manual pump-operated enema system, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4453", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adhesive remover or solvent (for tape, cement or other adhesive), per ounce", "description": "Adhesive remover or solvent (for tape, cement or other adhesive), per ounce", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adhesive remover, wipes, any type, each", "description": "Adhesive remover, wipes, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4456", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enema bag with tubing, reusable", "description": "Enema bag with tubing, reusable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4458", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual pump-operated enema system, includes balloon, catheter and all accessories, reusable, any type", "description": "Manual pump-operated enema system, includes balloon, catheter and all accessories, reusable, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4459", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical dressing holder, non-reusable, each", "description": "Surgical dressing holder, non-reusable, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4461", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical dressing holder, reusable, each", "description": "Surgical dressing holder, reusable, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4463", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-elastic binder for extremity", "description": "Non-elastic binder for extremity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each", "description": "Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4466", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Belt, strap, sleeve, garment, or covering, any type", "description": "Belt, strap, sleeve, garment, or covering, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4467", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gravlee jet washer", "description": "Gravlee jet washer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vabra aspirator", "description": "Vabra aspirator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostoma filter, any type, any size, each", "description": "Tracheostoma filter, any type, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4481", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Moisture exchanger, disposable, for use with invasive mechanical ventilation", "description": "Moisture exchanger, disposable, for use with invasive mechanical ventilation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4483", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical stockings above knee length, each", "description": "Surgical stockings above knee length, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical stockings thigh length, each", "description": "Surgical stockings thigh length, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4495", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical stockings below knee length, each", "description": "Surgical stockings below knee length, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical stockings full length, each", "description": "Surgical stockings full length, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence garment, any type, (e.g., brief, diaper), each", "description": "Incontinence garment, any type, (e.g., brief, diaper), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical trays", "description": "Surgical trays", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-disposable underpads, all sizes", "description": "Non-disposable underpads, all sizes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4553", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable underpads, all sizes", "description": "Disposable underpads, all sizes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4554", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only", "description": "Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4555", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrodes, (e.g., apnea monitor), per pair", "description": "Electrodes, (e.g., apnea monitor), per pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4556", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead wires, (e.g., apnea monitor), per pair", "description": "Lead wires, (e.g., apnea monitor), per pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4557", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz", "description": "Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4558", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coupling gel or paste, for use with ultrasound device, per oz", "description": "Coupling gel or paste, for use with ultrasound device, per oz", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4559", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pessary, rubber, any type", "description": "Pessary, rubber, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4561", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pessary, non rubber, any type", "description": "Pessary, non rubber, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each", "description": "Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4563", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Slings", "description": "Slings", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4565", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment", "description": "Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4566", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Splint", "description": "Splint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Topical hyperbaric oxygen chamber, disposable", "description": "Topical hyperbaric oxygen chamber, disposable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4575", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies (e.g., plaster)", "description": "Cast supplies (e.g., plaster)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Special casting material (e.g., fiberglass)", "description": "Special casting material (e.g., fiberglass)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)", "description": "Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4595", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sleeve for intermittent limb compression device, replacement only, each", "description": "Sleeve for intermittent limb compression device, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lithium ion battery, rechargeable, for non-prosthetic use, replacement", "description": "Lithium ion battery, rechargeable, for non-prosthetic use, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4601", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each", "description": "Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4602", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tubing with integrated heating element for use with positive airway pressure device", "description": "Tubing with integrated heating element for use with positive airway pressure device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheal suction catheter, closed system, each", "description": "Tracheal suction catheter, closed system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4605", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen probe for use with oximeter device, replacement", "description": "Oxygen probe for use with oximeter device, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transtracheal oxygen catheter, each", "description": "Transtracheal oxygen catheter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4608", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery, heavy duty; replacement for patient owned ventilator", "description": "Battery, heavy duty; replacement for patient owned ventilator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4611", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery cables; replacement for patient-owned ventilator", "description": "Battery cables; replacement for patient-owned ventilator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4612", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery charger; replacement for patient-owned ventilator", "description": "Battery charger; replacement for patient-owned ventilator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4613", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Peak expiratory flow rate meter, hand held", "description": "Peak expiratory flow rate meter, hand held", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4614", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cannula, nasal", "description": "Cannula, nasal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tubing (oxygen), per foot", "description": "Tubing (oxygen), per foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4616", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mouth piece", "description": "Mouth piece", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4617", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breathing circuits", "description": "Breathing circuits", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4618", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Face tent", "description": "Face tent", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4619", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Variable concentration mask", "description": "Variable concentration mask", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy, inner cannula", "description": "Tracheostomy, inner cannula", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4623", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheal suction catheter, any type other than closed system, each", "description": "Tracheal suction catheter, any type other than closed system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy care kit for new tracheostomy", "description": "Tracheostomy care kit for new tracheostomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy cleaning brush, each", "description": "Tracheostomy cleaning brush, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler", "description": "Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oropharyngeal suction catheter, each", "description": "Oropharyngeal suction catheter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy care kit for established tracheostomy", "description": "Tracheostomy care kit for established tracheostomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient", "description": "Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement bulb/lamp for ultraviolet light therapy system, each", "description": "Replacement bulb/lamp for ultraviolet light therapy system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4633", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement bulb for therapeutic light box, tabletop model", "description": "Replacement bulb for therapeutic light box, tabletop model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4634", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Underarm pad, crutch, replacement, each", "description": "Underarm pad, crutch, replacement, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement, handgrip, cane, crutch, or walker, each", "description": "Replacement, handgrip, cane, crutch, or walker, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement, tip, cane, crutch, walker, each.", "description": "Replacement, tip, cane, crutch, walker, each.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery for patient-owned ear pulse generator, each", "description": "Replacement battery for patient-owned ear pulse generator, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement pad for infrared heating pad system, each", "description": "Replacement pad for infrared heating pad system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4639", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement pad for use with medically necessary alternating pressure pad owned by patient", "description": "Replacement pad for use with medically necessary alternating pressure pad owned by patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiopharmaceutical, diagnostic, not otherwise classified", "description": "Radiopharmaceutical, diagnostic, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries", "description": "Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tissue marker, implantable, any type, each", "description": "Tissue marker, implantable, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4648", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical supply; miscellaneous", "description": "Surgical supply; miscellaneous", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4649", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable radiation dosimeter, each", "description": "Implantable radiation dosimeter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Calibrated microcapillary tube, each", "description": "Calibrated microcapillary tube, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4651", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Microcapillary tube sealant", "description": "Microcapillary tube sealant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4652", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Peritoneal dialysis catheter anchoring device, belt, each", "description": "Peritoneal dialysis catheter anchoring device, belt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4653", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Syringe, with or without needle, each", "description": "Syringe, with or without needle, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4657", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphygmomanometer/blood pressure apparatus with cuff and stethoscope", "description": "Sphygmomanometer/blood pressure apparatus with cuff and stethoscope", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood pressure cuff only", "description": "Blood pressure cuff only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4663", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Automatic blood pressure monitor", "description": "Automatic blood pressure monitor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable cycler set used with cycler dialysis machine, each", "description": "Disposable cycler set used with cycler dialysis machine, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4671", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drainage extension line, sterile, for dialysis, each", "description": "Drainage extension line, sterile, for dialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4672", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extension line with easy lock connectors, used with dialysis", "description": "Extension line with easy lock connectors, used with dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4673", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz", "description": "Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4674", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Activated carbon filter for hemodialysis, each", "description": "Activated carbon filter for hemodialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each", "description": "Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4690", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bicarbonate concentrate, solution, for hemodialysis, per gallon", "description": "Bicarbonate concentrate, solution, for hemodialysis, per gallon", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4706", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bicarbonate concentrate, powder, for hemodialysis, per packet", "description": "Bicarbonate concentrate, powder, for hemodialysis, per packet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4707", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Acetate concentrate solution, for hemodialysis, per gallon", "description": "Acetate concentrate solution, for hemodialysis, per gallon", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4708", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Acid concentrate, solution, for hemodialysis, per gallon", "description": "Acid concentrate, solution, for hemodialysis, per gallon", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4709", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon", "description": "Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4714", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "\"y set\" tubing for peritoneal dialysis", "description": "\"y set\" tubing for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4719", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis", "description": "Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis", "description": "Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4721", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis", "description": "Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4722", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis", "description": "Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4723", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis", "description": "Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4724", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis", "description": "Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4725", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis", "description": "Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4726", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution, non-dextrose containing, 500 ml", "description": "Dialysate solution, non-dextrose containing, 500 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4728", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fistula cannulation set for hemodialysis, each", "description": "Fistula cannulation set for hemodialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Topical anesthetic, for dialysis, per gram", "description": "Topical anesthetic, for dialysis, per gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4736", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injectable anesthetic, for dialysis, per 10 ml", "description": "Injectable anesthetic, for dialysis, per 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4737", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shunt accessory, for hemodialysis, any type, each", "description": "Shunt accessory, for hemodialysis, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood tubing, arterial or venous, for hemodialysis, each", "description": "Blood tubing, arterial or venous, for hemodialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4750", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood tubing, arterial and venous combined, for hemodialysis, each", "description": "Blood tubing, arterial and venous combined, for hemodialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4755", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate solution test kit, for peritoneal dialysis, any type, each", "description": "Dialysate solution test kit, for peritoneal dialysis, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate concentrate, powder, additive for peritoneal dialysis, per packet", "description": "Dialysate concentrate, powder, additive for peritoneal dialysis, per packet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4765", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml", "description": "Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4766", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood collection tube, vacuum, for dialysis, per 50", "description": "Blood collection tube, vacuum, for dialysis, per 50", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Serum clotting time tube, for dialysis, per 50", "description": "Serum clotting time tube, for dialysis, per 50", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4771", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood glucose test strips, for dialysis, per 50", "description": "Blood glucose test strips, for dialysis, per 50", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4772", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Occult blood test strips, for dialysis, per 50", "description": "Occult blood test strips, for dialysis, per 50", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4773", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ammonia test strips, for dialysis, per 50", "description": "Ammonia test strips, for dialysis, per 50", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4774", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Protamine sulfate, for hemodialysis, per 50 mg", "description": "Protamine sulfate, for hemodialysis, per 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4802", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable catheter tips for peritoneal dialysis, per 10", "description": "Disposable catheter tips for peritoneal dialysis, per 10", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4860", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plumbing and/or electrical work for home hemodialysis equipment", "description": "Plumbing and/or electrical work for home hemodialysis equipment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4870", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contracts, repair and maintenance, for hemodialysis equipment", "description": "Contracts, repair and maintenance, for hemodialysis equipment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drain bag/bottle, for dialysis, each", "description": "Drain bag/bottle, for dialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4911", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous dialysis supplies, not otherwise specified", "description": "Miscellaneous dialysis supplies, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4913", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Venous pressure clamp, for hemodialysis, each", "description": "Venous pressure clamp, for hemodialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4918", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gloves, non-sterile, per 100", "description": "Gloves, non-sterile, per 100", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4927", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical mask, per 20", "description": "Surgical mask, per 20", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4928", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tourniquet for dialysis, each", "description": "Tourniquet for dialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4929", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gloves, sterile, per pair", "description": "Gloves, sterile, per pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral thermometer, reusable, any type, each", "description": "Oral thermometer, reusable, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4931", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rectal thermometer, reusable, any type, each", "description": "Rectal thermometer, reusable, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4932", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed; with barrier attached (1 piece), each", "description": "Ostomy pouch, closed; with barrier attached (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5051", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed; without barrier attached (1 piece), each", "description": "Ostomy pouch, closed; without barrier attached (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed; for use on faceplate, each", "description": "Ostomy pouch, closed; for use on faceplate, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5053", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, closed; for use on barrier with flange (2 piece), each", "description": "Ostomy pouch, closed; for use on barrier with flange (2 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5054", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stoma cap", "description": "Stoma cap", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each", "description": "Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5056", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each", "description": "Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5057", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable; with barrier attached, (1 piece), each", "description": "Ostomy pouch, drainable; with barrier attached, (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5061", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable; without barrier attached (1 piece), each", "description": "Ostomy pouch, drainable; without barrier attached (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5062", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each", "description": "Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5063", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary; with barrier attached (1 piece), each", "description": "Ostomy pouch, urinary; with barrier attached (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5071", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary; without barrier attached (1 piece), each", "description": "Ostomy pouch, urinary; without barrier attached (1 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5072", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy pouch, urinary; for use on barrier with flange (2 piece), each", "description": "Ostomy pouch, urinary; for use on barrier with flange (2 piece), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5073", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stoma plug or seal, any type", "description": "Stoma plug or seal, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5081", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Continent device; catheter for continent stoma", "description": "Continent device; catheter for continent stoma", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5082", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Continent device, stoma absorptive cover for continent stoma", "description": "Continent device, stoma absorptive cover for continent stoma", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ostomy accessory; convex insert", "description": "Ostomy accessory; convex insert", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5093", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bedside drainage bottle with or without tubing, rigid or expandable, each", "description": "Bedside drainage bottle with or without tubing, rigid or expandable, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urinary suspensory with leg bag, with or without tube, each", "description": "Urinary suspensory with leg bag, with or without tube, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each", "description": "Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg strap; latex, replacement only, per set", "description": "Leg strap; latex, replacement only, per set", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg strap; foam or fabric, replacement only, per set", "description": "Leg strap; foam or fabric, replacement only, per set", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5114", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin barrier, wipes or swabs, each", "description": "Skin barrier, wipes or swabs, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin barrier; solid, 6 x 6 or equivalent, each", "description": "Skin barrier; solid, 6 x 6 or equivalent, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin barrier; solid, 8 x 8 or equivalent, each", "description": "Skin barrier; solid, 8 x 8 or equivalent, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adhesive or non-adhesive; disk or foam pad", "description": "Adhesive or non-adhesive; disk or foam pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Appliance cleaner, incontinence and ostomy appliances, per 16 oz.", "description": "Appliance cleaner, incontinence and ostomy appliances, per 16 oz.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous catheter/tube anchoring device, adhesive skin attachment", "description": "Percutaneous catheter/tube anchoring device, adhesive skin attachment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe", "description": "For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe", "description": "For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe", "description": "For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe", "description": "For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe", "description": "For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe", "description": "For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe", "description": "For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe", "description": "For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe", "description": "For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each", "description": "For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each", "description": "For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each", "description": "For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5514", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card", "description": "Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen based wound filler, dry form, sterile, per gram of collagen", "description": "Collagen based wound filler, dry form, sterile, per gram of collagen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen based wound filler, gel/paste, per gram of collagen", "description": "Collagen based wound filler, gel/paste, per gram of collagen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen dressing, sterile, size 16 sq. in. or less, each", "description": "Collagen dressing, sterile, size 16 sq. in. or less, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each", "description": "Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen dressing, sterile, size more than 48 sq. in., each", "description": "Collagen dressing, sterile, size more than 48 sq. in., each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen dressing wound filler, sterile, per 6 inches", "description": "Collagen dressing wound filler, sterile, per 6 inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each", "description": "Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wound pouch, each", "description": "Wound pouch, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6154", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing", "description": "Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6196", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing", "description": "Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6197", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing", "description": "Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6198", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches", "description": "Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "description": "Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "description": "Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "description": "Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact layer, sterile, 16 sq. in. or less, each dressing", "description": "Contact layer, sterile, 16 sq. in. or less, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing", "description": "Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact layer, sterile, more than 48 sq. in., each dressing", "description": "Contact layer, sterile, more than 48 sq. in., each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "description": "Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "description": "Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "description": "Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "description": "Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foam dressing, wound filler, sterile, per gram", "description": "Foam dressing, wound filler, sterile, per gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6217", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "description": "Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6218", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "description": "Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6219", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "description": "Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "description": "Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6223", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "description": "Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6224", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6228", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6229", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "description": "Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing", "description": "Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6231", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing", "description": "Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6232", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing", "description": "Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6233", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6234", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6235", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "description": "Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6236", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "description": "Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6237", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "description": "Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6238", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "description": "Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6239", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocolloid dressing, wound filler, paste, sterile, per ounce", "description": "Hydrocolloid dressing, wound filler, paste, sterile, per ounce", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocolloid dressing, wound filler, dry form, sterile, per gram", "description": "Hydrocolloid dressing, wound filler, dry form, sterile, per gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6241", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6242", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6243", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "description": "Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6244", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "description": "Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "description": "Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "description": "Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrogel dressing, wound filler, gel, per fluid ounce", "description": "Hydrogel dressing, wound filler, gel, per fluid ounce", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin sealants, protectants, moisturizers, ointments, any type, any size", "description": "Skin sealants, protectants, moisturizers, ointments, any type, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6251", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6252", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "description": "Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6253", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "description": "Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6254", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "description": "Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "description": "Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6256", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transparent film, sterile, 16 sq. in. or less, each dressing", "description": "Transparent film, sterile, 16 sq. in. or less, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing", "description": "Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6258", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transparent film, sterile, more than 48 sq. in., each dressing", "description": "Transparent film, sterile, more than 48 sq. in., each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6259", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wound cleansers, any type, any size", "description": "Wound cleansers, any type, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wound filler, gel/paste, per fluid ounce, not otherwise specified", "description": "Wound filler, gel/paste, per fluid ounce, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6261", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wound filler, dry form, per gram, not otherwise specified", "description": "Wound filler, dry form, per gram, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6262", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard", "description": "Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6266", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6402", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6403", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "description": "Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6404", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard", "description": "Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6407", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Eye pad, sterile, each", "description": "Eye pad, sterile, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Eye pad, non-sterile, each", "description": "Eye pad, non-sterile, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6411", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Eye patch, occlusive, each", "description": "Eye patch, occlusive, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6412", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adhesive bandage, first-aid type, any size, each", "description": "Adhesive bandage, first-aid type, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6413", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard", "description": "Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6441", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard", "description": "Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6442", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard", "description": "Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6443", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard", "description": "Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6444", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard", "description": "Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6445", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard", "description": "Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6446", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard", "description": "Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6447", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Light compression bandage, elastic, knitted/woven, width less than three inches, per yard", "description": "Light compression bandage, elastic, knitted/woven, width less than three inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6448", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard", "description": "Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6449", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard", "description": "Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard", "description": "Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6451", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard", "description": "High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard", "description": "Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6453", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard", "description": "Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6454", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard", "description": "Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard", "description": "Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6456", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tubular dressing with or without elastic, any width, per linear yard", "description": "Tubular dressing with or without elastic, any width, per linear yard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6457", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "description": "Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Synthetic resorbable wound dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "description": "Synthetic resorbable wound dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6461", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, bodysuit (head to foot), custom fabricated", "description": "Compression burn garment, bodysuit (head to foot), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, chin strap, custom fabricated", "description": "Compression burn garment, chin strap, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, facial hood, custom fabricated", "description": "Compression burn garment, facial hood, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, glove to wrist, custom fabricated", "description": "Compression burn garment, glove to wrist, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, glove to elbow, custom fabricated", "description": "Compression burn garment, glove to elbow, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, glove to axilla, custom fabricated", "description": "Compression burn garment, glove to axilla, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, foot to knee length, custom fabricated", "description": "Compression burn garment, foot to knee length, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, foot to thigh length, custom fabricated", "description": "Compression burn garment, foot to thigh length, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated", "description": "Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated", "description": "Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, lower trunk including leg openings (panty), custom fabricated", "description": "Compression burn garment, lower trunk including leg openings (panty), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6511", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn garment, not otherwise classified", "description": "Compression burn garment, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression burn mask, face and/or neck, plastic or equal, custom fabricated", "description": "Compression burn mask, face and/or neck, plastic or equal, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, below knee, 18-30 mmhg, each", "description": "Gradient compression stocking, below knee, 18-30 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, below knee, 30-40 mmhg, each", "description": "Gradient compression stocking, below knee, 30-40 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6531", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, below knee, 40-50 mmhg, each", "description": "Gradient compression stocking, below knee, 40-50 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6532", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, thigh length, 18-30 mmhg, each", "description": "Gradient compression stocking, thigh length, 18-30 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6533", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, thigh length, 30-40 mmhg, each", "description": "Gradient compression stocking, thigh length, 30-40 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6534", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, thigh length, 40-50 mmhg, each", "description": "Gradient compression stocking, thigh length, 40-50 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6535", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, full length/chap style, 18-30 mmhg, each", "description": "Gradient compression stocking, full length/chap style, 18-30 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6536", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, full length/chap style, 30-40 mmhg, each", "description": "Gradient compression stocking, full length/chap style, 30-40 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6537", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, full length/chap style, 40-50 mmhg, each", "description": "Gradient compression stocking, full length/chap style, 40-50 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6538", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, waist length, 18-30 mmhg, each", "description": "Gradient compression stocking, waist length, 18-30 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6539", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, waist length, 30-40 mmhg, each", "description": "Gradient compression stocking, waist length, 30-40 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, waist length, 40-50 mmhg, each", "description": "Gradient compression stocking, waist length, 40-50 mmhg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6541", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking, garter belt", "description": "Gradient compression stocking, garter belt", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6544", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each", "description": "Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6545", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient compression stocking/sleeve, not otherwise specified", "description": "Gradient compression stocking/sleeve, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6549", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories", "description": "Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Canister, disposable, used with suction pump, each", "description": "Canister, disposable, used with suction pump, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Canister, non-disposable, used with suction pump, each", "description": "Canister, non-disposable, used with suction pump, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tubing, used with suction pump, each", "description": "Tubing, used with suction pump, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration set, with small volume nonfiltered pneumatic nebulizer, disposable", "description": "Administration set, with small volume nonfiltered pneumatic nebulizer, disposable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Small volume nonfiltered pneumatic nebulizer, disposable", "description": "Small volume nonfiltered pneumatic nebulizer, disposable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable", "description": "Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration set, with small volume filtered pneumatic nebulizer", "description": "Administration set, with small volume filtered pneumatic nebulizer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Large volume nebulizer, disposable, unfilled, used with aerosol compressor", "description": "Large volume nebulizer, disposable, unfilled, used with aerosol compressor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Large volume nebulizer, disposable, prefilled, used with aerosol compressor", "description": "Large volume nebulizer, disposable, prefilled, used with aerosol compressor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer", "description": "Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Corrugated tubing, disposable, used with large volume nebulizer, 100 feet", "description": "Corrugated tubing, disposable, used with large volume nebulizer, 100 feet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet", "description": "Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Water collection device, used with large volume nebulizer", "description": "Water collection device, used with large volume nebulizer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter, disposable, used with aerosol compressor or ultrasonic generator", "description": "Filter, disposable, used with aerosol compressor or ultrasonic generator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter, nondisposable, used with aerosol compressor or ultrasonic generator", "description": "Filter, nondisposable, used with aerosol compressor or ultrasonic generator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aerosol mask, used with dme nebulizer", "description": "Aerosol mask, used with dme nebulizer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dome and mouthpiece, used with small volume ultrasonic nebulizer", "description": "Dome and mouthpiece, used with small volume ultrasonic nebulizer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen", "description": "Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Water, distilled, used with large volume nebulizer, 1000 ml", "description": "Water, distilled, used with large volume nebulizer, 1000 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interface for cough stimulating device, includes all components, replacement only", "description": "Interface for cough stimulating device, includes all components, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each", "description": "High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each", "description": "High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Combination oral/nasal mask, used with continuous positive airway pressure device, each", "description": "Combination oral/nasal mask, used with continuous positive airway pressure device, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral cushion for combination oral/nasal mask, replacement only, each", "description": "Oral cushion for combination oral/nasal mask, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasal pillows for combination oral/nasal mask, replacement only, pair", "description": "Nasal pillows for combination oral/nasal mask, replacement only, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Full face mask used with positive airway pressure device, each", "description": "Full face mask used with positive airway pressure device, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Face mask interface, replacement for full face mask, each", "description": "Face mask interface, replacement for full face mask, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cushion for use on nasal mask interface, replacement only, each", "description": "Cushion for use on nasal mask interface, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pillow for use on nasal cannula type interface, replacement only, pair", "description": "Pillow for use on nasal cannula type interface, replacement only, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap", "description": "Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Headgear used with positive airway pressure device", "description": "Headgear used with positive airway pressure device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chinstrap used with positive airway pressure device", "description": "Chinstrap used with positive airway pressure device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tubing used with positive airway pressure device", "description": "Tubing used with positive airway pressure device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter, disposable, used with positive airway pressure device", "description": "Filter, disposable, used with positive airway pressure device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter, non disposable, used with positive airway pressure device", "description": "Filter, non disposable, used with positive airway pressure device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "One way chest drain valve", "description": "One way chest drain valve", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Water seal drainage container and tubing for use with implanted chest tube", "description": "Water seal drainage container and tubing for use with implanted chest tube", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implanted pleural catheter, each", "description": "Implanted pleural catheter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vacuum drainage bottle and tubing for use with implanted catheter", "description": "Vacuum drainage bottle and tubing for use with implanted catheter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral interface used with positive airway pressure device, each", "description": "Oral interface used with positive airway pressure device, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Exhalation port with or without swivel used with accessories for positive airway devices, replacement only", "description": "Exhalation port with or without swivel used with accessories for positive airway devices, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Water chamber for humidifier, used with positive airway pressure device, replacement, each", "description": "Water chamber for humidifier, used with positive airway pressure device, replacement, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral interface used with respiratory suction pump, each", "description": "Oral interface used with respiratory suction pump, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each", "description": "Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7048", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostoma valve, including diaphragm, each", "description": "Tracheostoma valve, including diaphragm, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement diaphragm/faceplate for tracheostoma valve, each", "description": "Replacement diaphragm/faceplate for tracheostoma valve, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each", "description": "Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter for use in a tracheostoma heat and moisture exchange system, each", "description": "Filter for use in a tracheostoma heat and moisture exchange system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each", "description": "Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each", "description": "Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each", "description": "Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each", "description": "Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each", "description": "Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each", "description": "Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each", "description": "Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7521", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each", "description": "Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7522", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy shower protector, each", "description": "Tracheostomy shower protector, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7523", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostoma stent/stud/button, each", "description": "Tracheostoma stent/stud/button, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7524", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy mask, each", "description": "Tracheostomy mask, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7525", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy tube collar/holder, each", "description": "Tracheostomy tube collar/holder, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7526", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy/laryngectomy tube plug/stop, each", "description": "Tracheostomy/laryngectomy tube plug/stop, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7527", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Helmet, protective, soft, prefabricated, includes all components and accessories", "description": "Helmet, protective, soft, prefabricated, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A8000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Helmet, protective, hard, prefabricated, includes all components and accessories", "description": "Helmet, protective, hard, prefabricated, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A8001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Helmet, protective, soft, custom fabricated, includes all components and accessories", "description": "Helmet, protective, soft, custom fabricated, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A8002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Helmet, protective, hard, custom fabricated, includes all components and accessories", "description": "Helmet, protective, hard, custom fabricated, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A8003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Soft interface for helmet, replacement only", "description": "Soft interface for helmet, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A8004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-prescription drugs", "description": "Non-prescription drugs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Single vitamin/mineral/trace element, oral, per dose, not otherwise specified", "description": "Single vitamin/mineral/trace element, oral, per dose, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9152", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified", "description": "Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artificial saliva, 30 ml", "description": "Artificial saliva, 30 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9155", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker", "description": "Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-covered item or service", "description": "Non-covered item or service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wound suction, disposable, includes dressing, all accessories and components, any type, each", "description": "Wound suction, disposable, includes dressing, all accessories and components, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9272", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type", "description": "Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9273", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories", "description": "External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9274", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home glucose disposable monitor, includes test strips", "description": "Home glucose disposable monitor, includes test strips", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, one unit = 1 day supply", "description": "Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, one unit = 1 day supply", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9276", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transmitter; external, for use with interstitial continuous glucose monitoring system", "description": "Transmitter; external, for use with interstitial continuous glucose monitoring system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9277", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Receiver (monitor); external, for use with interstitial continuous glucose monitoring system", "description": "Receiver (monitor); external, for use with interstitial continuous glucose monitoring system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9278", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified", "description": "Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9279", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alert or alarm device, not otherwise classified", "description": "Alert or alarm device, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reaching/grabbing device, any type, any length, each", "description": "Reaching/grabbing device, any type, any length, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9281", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wig, any type, each", "description": "Wig, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9282", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot pressure off loading/supportive device, any type, each", "description": "Foot pressure off loading/supportive device, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9283", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spirometer, non-electronic, includes all accessories", "description": "Spirometer, non-electronic, includes all accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9284", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Inversion/eversion correction device", "description": "Inversion/eversion correction device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hygienic item or device, disposable or non-disposable, any type, each", "description": "Hygienic item or device, disposable or non-disposable, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9286", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Exercise equipment", "description": "Exercise equipment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m sestamibi, diagnostic, per study dose", "description": "Technetium tc-99m sestamibi, diagnostic, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m teboroxime, diagnostic, per study dose", "description": "Technetium tc-99m teboroxime, diagnostic, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m tetrofosmin, diagnostic, per study dose", "description": "Technetium tc-99m tetrofosmin, diagnostic, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries", "description": "Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries", "description": "Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Thallium tl-201 thallous chloride, diagnostic, per millicurie", "description": "Thallium tl-201 thallous chloride, diagnostic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries", "description": "Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie", "description": "Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-123 sodium iodide, diagnostic, per millicurie", "description": "Iodine i-123 sodium iodide, diagnostic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries", "description": "Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m pertechnetate, diagnostic, per millicurie", "description": "Technetium tc-99m pertechnetate, diagnostic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lutetium lu 177, dotatate, therapeutic, 1 millicurie", "description": "Lutetium lu 177, dotatate, therapeutic, 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Choline c-11, diagnostic, per study dose up to 20 millicuries", "description": "Choline c-11, diagnostic, per study dose up to 20 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries", "description": "Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9516", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie", "description": "Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9517", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries", "description": "Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries", "description": "Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9521", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries", "description": "Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9524", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries", "description": "Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9526", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-125, sodium iodide solution, therapeutic, per millicurie", "description": "Iodine i-125, sodium iodide solution, therapeutic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9527", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie", "description": "Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9528", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 sodium iodide solution, diagnostic, per millicurie", "description": "Iodine i-131 sodium iodide solution, diagnostic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9529", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 sodium iodide solution, therapeutic, per millicurie", "description": "Iodine i-131 sodium iodide solution, therapeutic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)", "description": "Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9531", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-125 serum albumin, diagnostic, per 5 microcuries", "description": "Iodine i-125 serum albumin, diagnostic, per 5 microcuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9532", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries", "description": "Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9536", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries", "description": "Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9537", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries", "description": "Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9538", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries", "description": "Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9539", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries", "description": "Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries", "description": "Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9541", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries", "description": "Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9542", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries", "description": "Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9543", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 tositumomab, diagnostic, per study dose", "description": "Iodine i-131 tositumomab, diagnostic, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9544", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 tositumomab, therapeutic, per treatment dose", "description": "Iodine i-131 tositumomab, therapeutic, per treatment dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9545", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie", "description": "Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9546", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie", "description": "Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9547", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indium in-111 pentetate, diagnostic, per 0.5 millicurie", "description": "Indium in-111 pentetate, diagnostic, per 0.5 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9548", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie", "description": "Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries", "description": "Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9551", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries", "description": "Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9552", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries", "description": "Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9553", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries", "description": "Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9554", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries", "description": "Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9555", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gallium ga-67 citrate, diagnostic, per millicurie", "description": "Gallium ga-67 citrate, diagnostic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9556", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries", "description": "Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9557", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Xenon xe-133 gas, diagnostic, per 10 millicuries", "description": "Xenon xe-133 gas, diagnostic, per 10 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9558", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie", "description": "Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9559", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries", "description": "Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries", "description": "Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9561", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries", "description": "Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sodium phosphate p-32, therapeutic, per millicurie", "description": "Sodium phosphate p-32, therapeutic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9563", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chromic phosphate p-32 suspension, therapeutic, per millicurie", "description": "Chromic phosphate p-32 suspension, therapeutic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9564", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries", "description": "Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9566", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries", "description": "Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9567", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries", "description": "Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9568", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose", "description": "Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9569", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indium in-111 labeled autologous white blood cells, diagnostic, per study dose", "description": "Indium in-111 labeled autologous white blood cells, diagnostic, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indium in-111 labeled autologous platelets, diagnostic, per study dose", "description": "Indium in-111 labeled autologous platelets, diagnostic, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9571", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries", "description": "Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9572", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gadoterate meglumine, 0.1 ml", "description": "Injection, gadoterate meglumine, 0.1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9575", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gadoteridol, (prohance multipack), per ml", "description": "Injection, gadoteridol, (prohance multipack), per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9576", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gadobenate dimeglumine (multihance), per ml", "description": "Injection, gadobenate dimeglumine (multihance), per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9577", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gadobenate dimeglumine (multihance multipack), per ml", "description": "Injection, gadobenate dimeglumine (multihance multipack), per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9578", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml", "description": "Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9579", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries", "description": "Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gadoxetate disodium, 1 ml", "description": "Injection, gadoxetate disodium, 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9581", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries", "description": "Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9582", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gadofosveset trisodium, 1 ml", "description": "Injection, gadofosveset trisodium, 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9583", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries", "description": "Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9584", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gadobutrol, 0.1 ml", "description": "Injection, gadobutrol, 0.1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9585", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Florbetapir f18, diagnostic, per study dose, up to 10 millicuries", "description": "Florbetapir f18, diagnostic, per study dose, up to 10 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9586", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gallium ga-68, dotatate, diagnostic, 0.1 millicurie", "description": "Gallium ga-68, dotatate, diagnostic, 0.1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9587", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fluciclovine f-18, diagnostic, 1 millicurie", "description": "Fluciclovine f-18, diagnostic, 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9588", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Instillation, hexaminolevulinate hydrochloride, 100 mg", "description": "Instillation, hexaminolevulinate hydrochloride, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9589", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131, iobenguane, 1 millicurie", "description": "Iodine i-131, iobenguane, 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fluoroestradiol f 18, diagnostic, 1 millicurie", "description": "Fluoroestradiol f 18, diagnostic, 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9591", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Copper cu-64, dotatate, diagnostic, 1 millicurie", "description": "Copper cu-64, dotatate, diagnostic, 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9592", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie", "description": "Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9593", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie", "description": "Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9594", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified", "description": "Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9597", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified", "description": "Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9598", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified", "description": "Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9599", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Strontium sr-89 chloride, therapeutic, per millicurie", "description": "Strontium sr-89 chloride, therapeutic, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries", "description": "Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radium ra-223 dichloride, therapeutic, per microcurie", "description": "Radium ra-223 dichloride, therapeutic, per microcurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-radioactive contrast imaging material, not otherwise classified, per study", "description": "Non-radioactive contrast imaging material, not otherwise classified, per study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9698", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiopharmaceutical, therapeutic, not otherwise classified", "description": "Radiopharmaceutical, therapeutic, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supply of injectable contrast material for use in echocardiography, per study", "description": "Supply of injectable contrast material for use in echocardiography, per study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous dme supply, accessory, and/or service component of another hcpcs code", "description": "Miscellaneous dme supply, accessory, and/or service component of another hcpcs code", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dme delivery, set up, and/or dispensing service component of another hcpcs code", "description": "Dme delivery, set up, and/or dispensing service component of another hcpcs code", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9901", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous dme supply or accessory, not otherwise specified", "description": "Miscellaneous dme supply or accessory, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape", "description": "Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape", "description": "Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape", "description": "Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasogastric tubing with stylet", "description": "Nasogastric tubing with stylet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4081", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasogastric tubing without stylet", "description": "Nasogastric tubing without stylet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4082", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stomach tube - levine type", "description": "Stomach tube - levine type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gastrostomy/jejunostomy tube, standard, any material, any type, each", "description": "Gastrostomy/jejunostomy tube, standard, any material, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4087", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gastrostomy/jejunostomy tube, low-profile, any material, any type, each", "description": "Gastrostomy/jejunostomy tube, low-profile, any material, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4088", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Food thickener, administered orally, per ounce", "description": "Food thickener, administered orally, per ounce", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit", "description": "Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit", "description": "Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4103", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Additive for enteral formula (e.g., fiber)", "description": "Additive for enteral formula (e.g., fiber)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4104", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "In-line cartridge containing digestive enzyme(s) for enteral feeding, each", "description": "In-line cartridge containing digestive enzyme(s) for enteral feeding, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4149", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4152", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4154", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4155", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4157", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4158", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4159", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "description": "Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix", "description": "Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4164", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix", "description": "Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4168", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition solution; amino acid, 5.5% through 7%, (500 ml = 1 unit) - home mix", "description": "Parenteral nutrition solution; amino acid, 5.5% through 7%, (500 ml = 1 unit) - home mix", 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"additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix", "description": "Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4178", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix", "description": "Parenteral nutrition 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"expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Omegaven, 10 grams lipids", "description": "Omegaven, 10 grams lipids", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4187", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix", "description": "Parenteral nutrition solution; 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], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day", "description": "Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition supply kit; premix, per day", "description": "Parenteral nutrition supply kit; premix, per day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition supply kit; home mix, per day", "description": "Parenteral nutrition supply kit; home mix, per day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B4222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, 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electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B5100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino acids-freamine-hbc-premix", "description": "Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino 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"billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enteral nutrition infusion pump, any type", "description": "Enteral nutrition infusion pump, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B9002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition infusion pump, portable", "description": "Parenteral nutrition infusion pump, portable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B9004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral nutrition infusion pump, stationary", "description": "Parenteral nutrition infusion pump, stationary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B9006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Noc for enteral supplies", "description": "Noc for enteral supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B9998", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Noc for parenteral supplies", "description": "Noc for parenteral supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "B9999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemostatic agent, gastrointestinal, topical", "description": "Hemostatic agent, gastrointestinal, topical", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravertebral body fracture augmentation with implant (e.g., metal, polymer)", "description": "Intravertebral body fracture augmentation with implant (e.g., metal, polymer)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1062", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval", "description": "Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)", "description": "Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1713", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, transluminal atherectomy, directional", "description": "Catheter, transluminal atherectomy, directional", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1714", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy needle", "description": "Brachytherapy needle", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1715", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, gold-198, per source", "description": "Brachytherapy source, non-stranded, gold-198, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1716", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, high dose rate iridium-192, per source", "description": "Brachytherapy source, non-stranded, high dose rate iridium-192, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1717", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, 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"percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardioverter-defibrillator, single chamber (implantable)", "description": "Cardioverter-defibrillator, single chamber (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1722", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, transluminal atherectomy, rotational", "description": "Catheter, transluminal atherectomy, rotational", 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"2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, balloon dilatation, non-vascular", "description": "Catheter, balloon dilatation, non-vascular", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1726", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, balloon tissue dissector, non-vascular (insertable)", "description": "Catheter, balloon tissue dissector, non-vascular (insertable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1727", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, brachytherapy seed administration", "description": "Catheter, brachytherapy seed administration", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1728", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": 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100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, electrophysiology, diagnostic, other than 3d mapping (20 or more electrodes)", "description": "Catheter, electrophysiology, diagnostic, other than 3d mapping (20 or more electrodes)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1731", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, electrophysiology, diagnostic/ablation, 3d or vector mapping", "description": "Catheter, 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"percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)", "description": "Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1734", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Endoscope, single-use (i.e. disposable), upper gi, 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"additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, intravascular ultrasound", "description": "Catheter, intravascular ultrasound", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1753", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, intradiscal", "description": "Catheter, intradiscal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1754", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], 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"billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Closure device, vascular (implantable/insertable)", "description": "Closure device, vascular (implantable/insertable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, transluminal intravascular lithotripsy, coronary", "description": "Catheter, transluminal intravascular lithotripsy, coronary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1761", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Connective tissue, human (includes fascia lata)", "description": "Connective tissue, human (includes fascia lata)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1762", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Connective tissue, non-human (includes synthetic)", "description": 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{2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adhesion barrier", "description": "Adhesion barrier", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1765", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away", "description": "Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1766", 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"description": "Graft, vascular", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1768", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Guide wire", "description": "Guide wire", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1769", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Imaging coil, magnetic resonance (insertable)", "description": "Imaging coil, magnetic resonance (insertable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair device, urinary, incontinence, with sling graft", "description": "Repair device, urinary, incontinence, with sling graft", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1771", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion pump, programmable (implantable)", "description": "Infusion pump, programmable (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1772", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Retrieval device, insertable (used to retrieve fractured medical devices)", "description": "Retrieval device, insertable (used to retrieve fractured medical devices)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1773", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Joint device (implantable)", "description": "Joint device (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1776", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, cardioverter-defibrillator, endocardial single coil (implantable)", "description": "Lead, cardioverter-defibrillator, endocardial single coil (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1777", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, neurostimulator (implantable)", "description": "Lead, neurostimulator (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1778", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, pacemaker, transvenous vdd single pass", "description": "Lead, pacemaker, transvenous vdd single pass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1779", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lens, intraocular (new technology)", "description": "Lens, intraocular (new technology)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mesh (implantable)", "description": "Mesh (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1781", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Morcellator", "description": "Morcellator", 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"setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ocular device, intraoperative, detached retina", "description": "Ocular device, intraoperative, detached retina", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1784", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pacemaker, dual chamber, rate-responsive (implantable)", "description": "Pacemaker, dual chamber, rate-responsive (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1785", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pacemaker, single chamber, rate-responsive (implantable)", "description": "Pacemaker, single chamber, rate-responsive (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1786", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient programmer, neurostimulator", "description": "Patient programmer, neurostimulator", 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"service_code": [ "11" ] } ] } ] }, { "name": "Prosthesis, breast (implantable)", "description": "Prosthesis, breast (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1789", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthesis, penile, inflatable", "description": "Prosthesis, penile, inflatable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1813", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Retinal tamponade device, silicone oil", "description": "Retinal tamponade device, silicone oil", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1814", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthesis, urinary sphincter (implantable)", "description": "Prosthesis, urinary sphincter (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1815", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Receiver and/or transmitter, neurostimulator (implantable)", "description": "Receiver and/or transmitter, neurostimulator (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1816", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Septal defect implant system, intracardiac", "description": "Septal defect implant system, intracardiac", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1817", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Integrated keratoprosthesis", "description": "Integrated keratoprosthesis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1818", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical tissue localization and excision device (implantable)", "description": "Surgical tissue localization and excision device (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1819", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Generator, neurostimulator (implantable), with rechargeable battery and charging system", "description": "Generator, neurostimulator (implantable), with rechargeable battery and charging system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1820", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interspinous process distraction device (implantable)", "description": "Interspinous process distraction device (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1821", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Generator, neurostimulator (implantable), high frequency, with rechargeable battery and charging system", "description": "Generator, neurostimulator (implantable), high frequency, with rechargeable battery and charging system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1822", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads", "description": "Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1823", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Generator, cardiac contractility modulation (implantable)", "description": "Generator, cardiac contractility modulation (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1824", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Generator, neurostimulator (implantable), non-rechargeable with carotid sinus baroreceptor stimulation lead(s)", "description": "Generator, neurostimulator (implantable), non-rechargeable with carotid sinus baroreceptor stimulation lead(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1825", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Powered bone marrow biopsy needle", "description": "Powered bone marrow biopsy needle", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Personalized, anterior and lateral interbody cage (implantable)", "description": "Personalized, anterior and lateral interbody cage (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1831", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iris prosthesis", "description": "Iris prosthesis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1839", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lens, intraocular (telescopic)", "description": "Lens, intraocular (telescopic)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Retinal prosthesis, includes all internal and external components", "description": "Retinal prosthesis, includes all internal and external components", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1841", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Retinal prosthesis, includes all internal and external components; add-on to c1841", "description": "Retinal prosthesis, includes all internal and external components; add-on to c1841", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1842", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin substitute, synthetic, resorbable, per square centimeter", "description": "Skin substitute, synthetic, resorbable, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1849", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stent, coated/covered, with delivery system", "description": "Stent, coated/covered, with delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1874", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stent, coated/covered, without delivery system", "description": "Stent, coated/covered, without delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1875", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stent, non-coated/non-covered, with delivery system", "description": "Stent, non-coated/non-covered, with delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1876", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stent, non-coated/non-covered, without delivery system", "description": "Stent, non-coated/non-covered, without delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1877", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Material for vocal cord medialization, synthetic (implantable)", "description": "Material for vocal cord medialization, synthetic (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1878", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vena cava filter", "description": "Vena cava filter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1880", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysis access system (implantable)", "description": "Dialysis access system (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1881", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardioverter-defibrillator, other than single or dual chamber (implantable)", "description": "Cardioverter-defibrillator, other than single or dual chamber (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1882", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adapter/extension, pacing lead or neurostimulator lead (implantable)", "description": "Adapter/extension, pacing lead or neurostimulator lead (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1883", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Embolization protective system", "description": "Embolization protective system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1884", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, transluminal angioplasty, laser", "description": "Catheter, transluminal angioplasty, laser", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1885", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, extravascular tissue ablation, any modality (insertable)", "description": "Catheter, extravascular tissue ablation, any modality (insertable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1886", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, guiding (may include infusion/perfusion capability)", "description": "Catheter, guiding (may include infusion/perfusion capability)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1887", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, ablation, non-cardiac, endovascular (implantable)", "description": "Catheter, ablation, non-cardiac, endovascular (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1888", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable/insertable device, not otherwise classified", "description": "Implantable/insertable device, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1889", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No implantable/insertable device used with device-intensive procedures", "description": "No implantable/insertable device used with device-intensive procedures", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion pump, non-programmable, permanent (implantable)", "description": "Infusion pump, non-programmable, permanent (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1891", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away", "description": "Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1892", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away", "description": "Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1893", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser", "description": "Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1894", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, cardioverter-defibrillator, endocardial dual coil (implantable)", "description": "Lead, cardioverter-defibrillator, endocardial dual coil (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1895", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)", "description": "Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1896", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, neurostimulator test kit (implantable)", "description": "Lead, neurostimulator test kit (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1897", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, pacemaker, other than transvenous vdd single pass", "description": "Lead, pacemaker, other than transvenous vdd single pass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1898", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, pacemaker/cardioverter-defibrillator combination (implantable)", "description": "Lead, pacemaker/cardioverter-defibrillator combination (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1899", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lead, left ventricular coronary venous system", "description": "Lead, left ventricular coronary venous system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, pressure-generating, one-way valve, intermittently occlusive", "description": "Catheter, pressure-generating, one-way valve, intermittently occlusive", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C1982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Probe, image-guided, robotic, waterjet ablation", "description": "Probe, image-guided, robotic, waterjet ablation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2596", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lung biopsy plug with delivery system", "description": "Lung biopsy plug with delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2613", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Probe, percutaneous lumbar discectomy", "description": "Probe, percutaneous lumbar discectomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2614", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sealant, pulmonary, liquid", "description": "Sealant, pulmonary, liquid", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, yttrium-90, per source", "description": "Brachytherapy source, non-stranded, yttrium-90, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2616", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stent, non-coronary, temporary, without delivery system", "description": "Stent, non-coronary, temporary, without delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2617", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Probe/needle, cryoablation", "description": "Probe/needle, cryoablation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2618", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pacemaker, dual chamber, non rate-responsive (implantable)", "description": "Pacemaker, dual chamber, non rate-responsive (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2619", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pacemaker, single chamber, non rate-responsive (implantable)", "description": "Pacemaker, single chamber, non rate-responsive (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pacemaker, other than single or dual chamber (implantable)", "description": "Pacemaker, other than single or dual chamber (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2621", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthesis, penile, non-inflatable", "description": "Prosthesis, penile, non-inflatable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, transluminal angioplasty, drug-coated, non-laser", "description": "Catheter, transluminal angioplasty, drug-coated, non-laser", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2623", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable wireless pulmonary artery pressure sensor with delivery catheter, including all system components", "description": "Implantable wireless pulmonary artery pressure sensor with delivery catheter, including all system components", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stent, non-coronary, temporary, with delivery system", "description": "Stent, non-coronary, temporary, with delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion pump, non-programmable, temporary (implantable)", "description": "Infusion pump, non-programmable, temporary (implantable)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, suprapubic/cystoscopic", "description": "Catheter, suprapubic/cystoscopic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, occlusion", "description": "Catheter, occlusion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Introducer/sheath, other than guiding, other than intracardiac electrophysiological, laser", "description": "Introducer/sheath, other than guiding, other than intracardiac electrophysiological, laser", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, cool-tip", "description": "Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, cool-tip", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair device, urinary, incontinence, without sling graft", "description": "Repair device, urinary, incontinence, without sling graft", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mci (nist), per source", "description": "Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mci (nist), per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2634", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mci (nist), per source", "description": "Brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mci (nist), per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy linear source, non-stranded, palladium-103, per 1 mm", "description": "Brachytherapy linear source, non-stranded, palladium-103, per 1 mm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, ytterbium-169, per source", "description": "Brachytherapy source, non-stranded, ytterbium-169, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, stranded, iodine-125, per source", "description": "Brachytherapy source, stranded, iodine-125, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, iodine-125, per source", "description": "Brachytherapy source, non-stranded, iodine-125, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2639", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, stranded, palladium-103, per source", "description": "Brachytherapy source, stranded, palladium-103, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, palladium-103, per source", "description": "Brachytherapy source, non-stranded, palladium-103, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, stranded, cesium-131, per source", "description": "Brachytherapy source, stranded, cesium-131, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, cesium-131, per source", "description": "Brachytherapy source, non-stranded, cesium-131, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2643", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, cesium-131 chloride solution, per millicurie", "description": "Brachytherapy source, cesium-131 chloride solution, per millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2644", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy planar source, palladium-103, per square millimeter", "description": "Brachytherapy planar source, palladium-103, per square millimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2645", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, stranded, not otherwise specified, per source", "description": "Brachytherapy source, stranded, not otherwise specified, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2698", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brachytherapy source, non-stranded, not otherwise specified, per source", "description": "Brachytherapy source, non-stranded, not otherwise specified, per source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C2699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area", "description": "Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C5271", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)", "description": "Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C5272", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children", "description": "Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C5273", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)", "description": "Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C5274", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area", "description": "Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C5275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)", "description": "Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C5276", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children", "description": "Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C5277", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)", "description": "Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C5278", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography with contrast, abdomen", "description": "Magnetic resonance angiography with contrast, abdomen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast, abdomen", "description": "Magnetic resonance angiography without contrast, abdomen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8901", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast followed by with contrast, abdomen", "description": "Magnetic resonance angiography without contrast followed by with contrast, abdomen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8902", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance imaging with contrast, breast; unilateral", "description": "Magnetic resonance imaging with contrast, breast; unilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8903", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance imaging without contrast, breast; unilateral", "description": "Magnetic resonance imaging without contrast, breast; unilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8904", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral", "description": "Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8905", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance imaging with contrast, breast; bilateral", "description": "Magnetic resonance imaging with contrast, breast; bilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8906", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance imaging without contrast, breast; bilateral", "description": "Magnetic resonance imaging without contrast, breast; bilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8907", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral", "description": "Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8908", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography with contrast, chest (excluding myocardium)", "description": "Magnetic resonance angiography with contrast, chest (excluding myocardium)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8909", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast, chest (excluding myocardium)", "description": "Magnetic resonance angiography without contrast, chest (excluding myocardium)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)", "description": "Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8911", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography with contrast, lower extremity", "description": "Magnetic resonance angiography with contrast, lower extremity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8912", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast, lower extremity", "description": "Magnetic resonance angiography without contrast, lower extremity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8913", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast followed by with contrast, lower extremity", "description": "Magnetic resonance angiography without contrast followed by with contrast, lower extremity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8914", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography with contrast, pelvis", "description": "Magnetic resonance angiography with contrast, pelvis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8918", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast, pelvis", "description": "Magnetic resonance angiography without contrast, pelvis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8919", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast followed by with contrast, pelvis", "description": "Magnetic resonance angiography without contrast followed by with contrast, pelvis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8920", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete", "description": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8921", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study", "description": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8922", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography", "description": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8923", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study", "description": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8924", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report", "description": "Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8925", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report", "description": "Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8926", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis", "description": "Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8927", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report", "description": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8928", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography", "description": "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8929", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision", "description": "Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography with contrast, spinal canal and contents", "description": "Magnetic resonance angiography with contrast, spinal canal and contents", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8931", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast, spinal canal and contents", "description": "Magnetic resonance angiography without contrast, spinal canal and contents", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8932", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents", "description": "Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8933", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography with contrast, upper extremity", "description": "Magnetic resonance angiography with contrast, upper extremity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8934", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance angiography without contrast, upper extremity", "description": "Magnetic resonance angiography without contrast, upper extremity", 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"additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure)", "description": "Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8937", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump", "description": "Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C8957", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": 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"2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triptorelin extended release, 3.75 mg", "description": "Injection, triptorelin extended release, 3.75 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, obinutuzumab, 10 mg", "description": "Injection, obinutuzumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9021", 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"billing_code_type_version": "2022", "billing_code": "C9028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, guselkumab, 1 mg", "description": "Injection, guselkumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, copanlisib, 1 mg", "description": "Injection, copanlisib, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lutetium lu 177, dotatate, therapeutic, 1 mci", "description": "Lutetium lu 177, dotatate, therapeutic, 1 mci", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, voretigene neparvovec-rzyl, 1 billion vector genome", "description": "Injection, voretigene neparvovec-rzyl, 1 billion vector genome", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fosnetupitant 235 mg and palonosetron 0.25 mg", "description": "Injection, fosnetupitant 235 mg and palonosetron 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dexamethasone 9%, intraocular, 1 mcg", "description": "Injection, dexamethasone 9%, intraocular, 1 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aripiprazole lauroxil (aristada initio), 1 mg", "description": "Injection, aripiprazole lauroxil (aristada initio), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, patisiran, 0.1 mg", "description": "Injection, patisiran, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, risperidone (perseris), 0.5 mg", "description": "Injection, risperidone (perseris), 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mogamulizumab-kpkc, 1 mg", "description": "Injection, mogamulizumab-kpkc, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, plazomicin, 5 mg", "description": "Injection, plazomicin, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fremanezumab-vfrm, 1mg", "description": "Injection, fremanezumab-vfrm, 1mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg", "description": "Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bendamustine hcl (belrapzo), 1 mg", "description": "Injection, bendamustine hcl (belrapzo), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, levoleucovorin, 1 mg", "description": "Injection, levoleucovorin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cemiplimab-rwlc, 1 mg", "description": "Injection, cemiplimab-rwlc, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, moxetumomab pasudotox-tdfk, 0.01 mg", "description": "Injection, moxetumomab pasudotox-tdfk, 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cocaine hydrochloride nasal solution for topical administration, 1 mg", "description": "Cocaine hydrochloride nasal solution for topical administration, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, caplacizumab-yhdp, 1 mg", "description": "Injection, caplacizumab-yhdp, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dexamethasone, lacrimal ophthalmic insert, 0.1 mg", "description": "Dexamethasone, lacrimal ophthalmic insert, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9048", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tagraxofusp-erzs, 10 mcg", "description": "Injection, tagraxofusp-erzs, 10 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9049", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, emapalumab-lzsg, 1 mg", "description": "Injection, emapalumab-lzsg, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, omadacycline, 1 mg", "description": "Injection, omadacycline, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9051", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ravulizumab-cwvz, 10 mg", "description": "Injection, ravulizumab-cwvz, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, crizanlizumab-tmca, 1 mg", "description": "Injection, crizanlizumab-tmca, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9053", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lefamulin (xenleta), 1 mg", "description": "Injection, lefamulin (xenleta), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9054", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, brexanolone, 1mg", "description": "Injection, brexanolone, 1mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, givosiran, 0.5 mg", "description": "Injection, givosiran, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9056", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cetirizine hydrochloride, 1 mg", "description": "Injection, cetirizine hydrochloride, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9057", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg", "description": "Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9058", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, meloxicam, 1 mg", "description": "Injection, meloxicam, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9059", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fluoroestradiol f18, diagnostic, 1 mci", "description": "Fluoroestradiol f18, diagnostic, 1 mci", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, teprotumumab-trbw, 10 mg", "description": "Injection, teprotumumab-trbw, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9061", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, daratumumab 10 mg and hyaluronidase-fihj", "description": "Injection, daratumumab 10 mg and hyaluronidase-fihj", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9062", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, eptinezumab-jjmr, 1 mg", "description": "Injection, eptinezumab-jjmr, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9063", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mitomycin pyelocalyceal instillation, 1 mg", "description": "Mitomycin pyelocalyceal instillation, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9064", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, romidepsin, non-lyophilized (e.g. liquid), 1mg", "description": "Injection, romidepsin, non-lyophilized (e.g. liquid), 1mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9065", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sacituzumab govitecan-hziy, 2.5 mg", "description": "Injection, sacituzumab govitecan-hziy, 2.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9066", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gallium ga-68, dotatoc, diagnostic, 0.01 mci", "description": "Gallium ga-68, dotatoc, diagnostic, 0.01 mci", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9067", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Copper cu-64, dotatate, diagnostic, 1 millicurie", "description": "Copper cu-64, dotatate, diagnostic, 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9068", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, belantamab mafodontin-blmf, 0.5 mg", "description": "Injection, belantamab mafodontin-blmf, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9069", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tafasitamab-cxix, 2 mg", "description": "Injection, tafasitamab-cxix, 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, viltolarsen, 10 mg", "description": "Injection, viltolarsen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9071", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin (asceniv), 500 mg", "description": "Injection, immune globulin (asceniv), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9072", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "description": "Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9073", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lumasiran, 0.5 mg", "description": "Injection, lumasiran, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9074", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, casimersen, 10 mg", "description": "Injection, casimersen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9075", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "description": "Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9076", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cabotegravir and rilpivirine, 2mg/3mg", "description": "Injection, cabotegravir and rilpivirine, 2mg/3mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9077", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trilaciclib, 1 mg", "description": "Injection, trilaciclib, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9078", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, evinacumab-dgnb, 5 mg", "description": "Injection, evinacumab-dgnb, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9079", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, melphalan flufenamide hydrochloride, 1 mg", "description": "Injection, melphalan flufenamide hydrochloride, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Idecabtagene vicleucel, up to 460 million autologous anti-bcma car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "description": "Idecabtagene vicleucel, up to 460 million autologous anti-bcma car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9081", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dostarlimab-gxly, 100 mg", "description": "Injection, dostarlimab-gxly, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9082", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amivantamab-vmjw, 10 mg", "description": "Injection, amivantamab-vmjw, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, loncastuximab tesirine-lpyl, 0.1 mg", "description": "Injection, loncastuximab tesirine-lpyl, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9084", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pantoprazole sodium, per vial", "description": "Injection, pantoprazole sodium, per vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, argatroban, per 5 mg", "description": "Injection, argatroban, per 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mometasone furoate sinus implant, 10 micrograms (sinuva)", "description": "Mometasone furoate sinus implant, 10 micrograms (sinuva)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity", "description": "Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9132", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor ix (antihemophilic factor, recombinant), rixubis, per i.u.", "description": "Factor ix (antihemophilic factor, recombinant), rixubis, per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9133", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor xiii (antihemophilic factor, recombinant), tretten, per 10 i.u.", "description": "Factor xiii (antihemophilic factor, recombinant), tretten, per 10 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9134", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor ix (antihemophilic factor, recombinant), alprolix, per i.u.", "description": "Factor ix (antihemophilic factor, recombinant), alprolix, per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9135", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, fc fusion protein, (recombinant), per i.u.", "description": "Injection, factor viii, fc fusion protein, (recombinant), per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9136", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u.", "description": "Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9137", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u.", "description": "Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9138", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u.", "description": "Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9139", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u.", "description": "Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u.", "description": "Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9141", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, clevidipine butyrate, 1 mg", "description": "Injection, clevidipine butyrate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml", "description": "Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lacosamide, 1 mg", "description": "Injection, lacosamide, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9254", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bevacizumab, 0.25 mg", "description": "Injection, bevacizumab, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hexaminolevulinate hydrochloride, 100 mg, per study dose", "description": "Injection, hexaminolevulinate hydrochloride, 100 mg, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lidocaine 70 mg/tetracaine 70 mg, per patch", "description": "Lidocaine 70 mg/tetracaine 70 mg, per patch", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bupivacaine liposome, 1 mg", "description": "Injection, bupivacaine liposome, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, glucarpidase, 10 units", "description": "Injection, glucarpidase, 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9293", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Puraply, and puraply antimicrobial, any type, per square centimeter", "description": "Puraply, and puraply antimicrobial, any type, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9349", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Microporous collagen implantable tube (neuragen nerve guide), per centimeter length", "description": "Microporous collagen implantable tube (neuragen nerve guide), per centimeter length", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9352", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Microporous collagen implantable slit tube (neurawrap nerve protector), per centimeter length", "description": "Microporous collagen implantable slit tube (neurawrap nerve protector), per centimeter length", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9353", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Acellular pericardial tissue matrix of non-human origin (veritas), per square centimeter", "description": "Acellular pericardial tissue matrix of non-human origin (veritas), per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9354", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen nerve cuff (neuromatrix), per 0.5 centimeter length", "description": "Collagen nerve cuff (neuromatrix), per 0.5 centimeter length", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9355", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (tenoglide tendon protector sheet), per square centimeter", "description": "Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (tenoglide tendon protector sheet), per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9356", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermal substitute, native, non-denatured collagen, fetal bovine origin (surgimend collagen matrix), per 0.5 square centimeters", "description": "Dermal substitute, native, non-denatured collagen, fetal bovine origin (surgimend collagen matrix), per 0.5 square centimeters", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9358", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold putty, integra os osteoconductive scaffold putty), per 0.5 cc", "description": "Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold putty, integra os osteoconductive scaffold putty), per 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9359", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermal substitute, native, non-denatured collagen, neonatal bovine origin (surgimend collagen matrix), per 0.5 square centimeters", "description": "Dermal substitute, native, non-denatured collagen, neonatal bovine origin (surgimend collagen matrix), per 0.5 square centimeters", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen matrix nerve wrap (neuromend collagen nerve wrap), per 0.5 centimeter length", "description": "Collagen matrix nerve wrap (neuromend collagen nerve wrap), per 0.5 centimeter length", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9361", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold strip), per 0.5 cc", "description": "Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold strip), per 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9362", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin substitute, integra meshed bilayer wound matrix, per square centimeter", "description": "Skin substitute, integra meshed bilayer wound matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9363", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Porcine implant, permacol, per square centimeter", "description": "Porcine implant, permacol, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unclassified drugs or biologicals", "description": "Unclassified drugs or biologicals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9399", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 iobenguane, diagnostic, 1 millicurie", "description": "Iodine i-131 iobenguane, diagnostic, 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9407", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iodine i-131 iobenguane, therapeutic, 1 millicurie", "description": "Iodine i-131 iobenguane, therapeutic, 1 millicurie", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9408", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferric carboxymaltose, 1 mg", "description": "Injection, ferric carboxymaltose, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9441", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, belinostat, 10 mg", "description": "Injection, belinostat, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9442", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dalbavancin, 10 mg", "description": "Injection, dalbavancin, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9443", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oritavancin, 10 mg", "description": "Injection, oritavancin, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9444", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, c-1 esterase inhibitor (recombinant), ruconest, 10 units", "description": "Injection, c-1 esterase inhibitor (recombinant), ruconest, 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9445", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tedizolid phosphate, 1 mg", "description": "Injection, tedizolid phosphate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9446", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, phenylephrine and ketorolac, 4 ml vial", "description": "Injection, phenylephrine and ketorolac, 4 ml vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9447", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Netupitant 300 mg and palonosetron 0.5 mg, oral", "description": "Netupitant 300 mg and palonosetron 0.5 mg, oral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9448", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, blinatumomab, 1 mcg", "description": "Injection, blinatumomab, 1 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9449", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fluocinolone acetonide intravitreal implant, 0.01 mg", "description": "Injection, fluocinolone acetonide intravitreal implant, 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, peramivir, 1 mg", "description": "Injection, peramivir, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9451", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ceftolozane 50 mg and tazobactam 25 mg", "description": "Injection, ceftolozane 50 mg and tazobactam 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nivolumab, 1 mg", "description": "Injection, nivolumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9453", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pasireotide long acting, 1 mg", "description": "Injection, pasireotide long acting, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9454", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, siltuximab, 10 mg", "description": "Injection, siltuximab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, isavuconazonium sulfate, 1 mg", "description": "Injection, isavuconazonium sulfate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9456", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sulfur hexafluoride lipid microsphere, per ml", "description": "Injection, sulfur hexafluoride lipid microsphere, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9457", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries", "description": "Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9458", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries", "description": "Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9459", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cangrelor, 1 mg", "description": "Injection, cangrelor, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Choline c 11, diagnostic, per study dose", "description": "Choline c 11, diagnostic, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9461", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, delafloxacin, 1 mg", "description": "Injection, delafloxacin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9462", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aprepitant, 1 mg", "description": "Injection, aprepitant, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9463", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rolapitant, 0.5 mg", "description": "Injection, rolapitant, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9464", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, durolane, for intra-articular injection, per dose", "description": "Hyaluronan or derivative, durolane, for intra-articular injection, per dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, benralizumab, 1 mg", "description": "Injection, benralizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9466", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rituximab and hyaluronidase, 10 mg", "description": "Injection, rituximab and hyaluronidase, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9467", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u.", "description": "Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9468", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg", "description": "Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9469", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aripiprazole lauroxil, 1 mg", "description": "Injection, aripiprazole lauroxil, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9471", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, talimogene laherparepvec, 1 million plaque forming units (pfu)", "description": "Injection, talimogene laherparepvec, 1 million plaque forming units (pfu)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9472", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mepolizumab, 1 mg", "description": "Injection, mepolizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9473", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, irinotecan liposome, 1 mg", "description": "Injection, irinotecan liposome, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9474", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, necitumumab, 1 mg", "description": "Injection, necitumumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9475", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, daratumumab, 10 mg", "description": "Injection, daratumumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9476", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, elotuzumab, 1 mg", "description": "Injection, elotuzumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9477", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sebelipase alfa, 1 mg", "description": "Injection, sebelipase alfa, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9478", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Instillation, ciprofloxacin otic suspension, 6 mg", "description": "Instillation, ciprofloxacin otic suspension, 6 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9479", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trabectedin, 0.1 mg", "description": "Injection, trabectedin, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, reslizumab, 1 mg", "description": "Injection, reslizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9481", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sotalol hydrochloride, 1 mg", "description": "Injection, sotalol hydrochloride, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9482", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, atezolizumab, 10 mg", "description": "Injection, atezolizumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9483", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, eteplirsen, 10 mg", "description": "Injection, eteplirsen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9484", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, olaratumab, 10 mg", "description": "Injection, olaratumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, granisetron extended release, 0.1 mg", "description": "Injection, granisetron extended release, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9486", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ustekinumab, for intravenous injection, 1 mg", "description": "Ustekinumab, for intravenous injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9487", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, conivaptan hydrochloride, 1 mg", "description": "Injection, conivaptan hydrochloride, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9488", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nusinersen, 0.1 mg", "description": "Injection, nusinersen, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9489", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bezlotoxumab, 10 mg", "description": "Injection, bezlotoxumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, avelumab, 10 mg", "description": "Injection, avelumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9491", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, durvalumab, 10 mg", "description": "Injection, durvalumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9492", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, edaravone, 1 mg", "description": "Injection, edaravone, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9493", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ocrelizumab, 1 mg", "description": "Injection, ocrelizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9494", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Loxapine, inhalation powder, 10 mg", "description": "Loxapine, inhalation powder, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9497", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch", "description": "Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)", "description": "Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9601", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch", "description": "Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9602", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)", "description": "Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9603", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel", "description": "Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)", "description": "Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9605", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel", "description": "Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel", "description": "Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9607", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)", "description": "Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9608", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Endoscopic full-thickness plication of the stomach using endoscopic plication system (eps); includes endoscopy", "description": "Endoscopic full-thickness plication of the stomach using endoscopic plication system (eps); includes endoscopy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9724", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Placement of endorectal intracavitary applicator for high intensity brachytherapy", "description": "Placement of endorectal intracavitary applicator for high intensity brachytherapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9725", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure", "description": "Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9726", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion of implants into the soft palate; minimum of three implants", "description": "Insertion of implants into the soft palate; minimum of three implants", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9727", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple", "description": "Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9728", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-ophthalmic fluorescent vascular angiography", "description": "Non-ophthalmic fluorescent vascular angiography", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9733", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance", "description": "Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9734", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anoscopy; with directed submucosal injection(s), any substance", "description": "Anoscopy; with directed submucosal injection(s), any substance", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9735", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laparoscopy, surgical, esophageal sphincter augmentation with device (e.g., magnetic band)", "description": "Laparoscopy, surgical, esophageal sphincter augmentation with device (e.g., magnetic band)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9737", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)", "description": "Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9738", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants", "description": "Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9739", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants", "description": "Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report", "description": "Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9741", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed", "description": "Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9742", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)", "description": "Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9743", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultrasound, abdominal, with contrast", "description": "Ultrasound, abdominal, with contrast", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9744", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasal endoscopy, surgical; balloon dilation of eustachian tube", "description": "Nasal endoscopy, surgical; balloon dilation of eustachian tube", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9745", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transperineal implantation of permanent adjustable balloon continence device, with cystourethroscopy, when performed and/or fluoroscopy, when performed", "description": "Transperineal implantation of permanent adjustable balloon continence device, with cystourethroscopy, when performed and/or fluoroscopy, when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9746", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ablation of prostate, transrectal, high intensity focused ultrasound (hifu), including imaging guidance", "description": "Ablation of prostate, transrectal, high intensity focused ultrasound (hifu), including imaging guidance", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9747", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy", "description": "Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9748", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair of nasal vestibular lateral wall stenosis with implant(s)", "description": "Repair of nasal vestibular lateral wall stenosis with implant(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9749", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation and peri-operative interrogation and programming; complete system (includes device and electrode)", "description": "Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation and peri-operative interrogation and programming; complete system (includes device and electrode)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9750", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, computer-assisted, image-guided navigation, and endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]) and all mediastinal and/or hilar lymph node stations or structures and therapeutic intervention(s)", "description": "Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, computer-assisted, image-guided navigation, and endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]) and all mediastinal and/or hilar lymph node stations or structures and therapeutic intervention(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9751", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Destruction of intraosseous basivertebral nerve, first two vertebral bodies, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum", "description": "Destruction of intraosseous basivertebral nerve, first two vertebral bodies, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9752", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Destruction of intraosseous basivertebral nerve, each additional vertebral body, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum (list separately in addition to code for primary procedure)", "description": "Destruction of intraosseous basivertebral nerve, each additional vertebral body, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9753", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Creation of arteriovenous fistula, percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed)", "description": "Creation of arteriovenous fistula, percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9754", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Creation of arteriovenous fistula, percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, when performed) and fistulogram(s), angiography, venography, and/or ultrasound, with radiologic supervision and interpretation, when performed", "description": "Creation of arteriovenous fistula, percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, when performed) and fistulogram(s), angiography, venography, and/or ultrasound, with radiologic supervision and interpretation, when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9755", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primary procedure)", "description": "Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9756", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar", "description": "Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9757", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study", "description": "Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9758", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when performed", "description": "Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9759", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study", "description": "Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if applicable", "description": "Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if applicable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9761", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging", "description": "Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9762", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging", "description": "Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9763", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed", "description": "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9764", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed", "description": "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9765", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed", "description": "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9766", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed", "description": "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9767", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)", "description": "Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9768", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts", "description": "Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9769", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent", "description": "Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral", "description": "Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9771", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed", "description": "Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9772", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed", "description": "Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9773", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed", "description": "Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9774", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel (s), when performed", "description": "Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel (s), when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9775", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green (icg) (list separately in addition to code for primary procedure)", "description": "Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green (icg) (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9776", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Esophageal mucosal integrity testing by electrical impedance, transoral (list separately in addition to code for primary procedure)", "description": "Esophageal mucosal integrity testing by electrical impedance, transoral (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9777", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous)", "description": "Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9778", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed", "description": "Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9779", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance", "description": "Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies", "description": "Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source", "description": "Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9803", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiolabeled product provided during a hospital inpatient stay", "description": "Radiolabeled product provided during a hospital inpatient stay", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9898", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage", "description": "Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "C9899", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cane, includes canes of all materials, adjustable or fixed, with tip", "description": "Cane, includes canes of all materials, adjustable or fixed, with tip", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips", "description": "Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips", "description": "Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips", "description": "Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0111", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips", "description": "Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip", "description": "Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips", "description": "Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0114", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each", "description": "Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0116", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutch, underarm, articulating, spring assisted, each", "description": "Crutch, underarm, articulating, spring assisted, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutch substitute, lower leg platform, with or without wheels, each", "description": "Crutch substitute, lower leg platform, with or without wheels, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0118", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, rigid (pickup), adjustable or fixed height", "description": "Walker, rigid (pickup), adjustable or fixed height", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, folding (pickup), adjustable or fixed height", "description": "Walker, folding (pickup), adjustable or fixed height", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0135", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, with trunk support, adjustable or fixed height, any type", "description": "Walker, with trunk support, adjustable or fixed height, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, rigid, wheeled, adjustable or fixed height", "description": "Walker, rigid, wheeled, adjustable or fixed height", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0141", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, folding, wheeled, adjustable or fixed height", "description": "Walker, folding, wheeled, adjustable or fixed height", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0143", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat", "description": "Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0144", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, heavy duty, multiple braking system, variable wheel resistance", "description": "Walker, heavy duty, multiple braking system, variable wheel resistance", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0147", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, heavy duty, without wheels, rigid or folding, any type, each", "description": "Walker, heavy duty, without wheels, rigid or folding, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0148", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walker, heavy duty, wheeled, rigid or folding, any type", "description": "Walker, heavy duty, wheeled, rigid or folding, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0149", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platform attachment, forearm crutch, each", "description": "Platform attachment, forearm crutch, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platform attachment, walker, each", "description": "Platform attachment, walker, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0154", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheel attachment, rigid pick-up walker, per pair", "description": "Wheel attachment, rigid pick-up walker, per pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0155", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Seat attachment, walker", "description": "Seat attachment, walker", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0156", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crutch attachment, walker, each", "description": "Crutch attachment, walker, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0157", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg extensions for walker, per set of four (4)", "description": "Leg extensions for walker, per set of four (4)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0158", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brake attachment for wheeled walker, replacement, each", "description": "Brake attachment for wheeled walker, replacement, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0159", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sitz type bath or equipment, portable, used with or without commode", "description": "Sitz type bath or equipment, portable, used with or without commode", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s", "description": "Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sitz bath chair", "description": "Sitz bath chair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Commode chair, mobile or stationary, with fixed arms", "description": "Commode chair, mobile or stationary, with fixed arms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0163", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Commode chair, mobile or stationary, with detachable arms", "description": "Commode chair, mobile or stationary, with detachable arms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0165", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pail or pan for use with commode chair, replacement only", "description": "Pail or pan for use with commode chair, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0167", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each", "description": "Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0168", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Commode chair with integrated seat lift mechanism, electric, any type", "description": "Commode chair with integrated seat lift mechanism, electric, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Commode chair with integrated seat lift mechanism, non-electric, any type", "description": "Commode chair with integrated seat lift mechanism, non-electric, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Seat lift mechanism placed over or on top of toilet, any type", "description": "Seat lift mechanism placed over or on top of toilet, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0172", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot rest, for use with commode chair, each", "description": "Foot rest, for use with commode chair, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty", "description": "Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pump for alternating pressure pad, for replacement only", "description": "Pump for alternating pressure pad, for replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0182", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dry pressure mattress", "description": "Dry pressure mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0184", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gel or gel-like pressure pad for mattress, standard mattress length and width", "description": "Gel or gel-like pressure pad for mattress, standard mattress length and width", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Air pressure mattress", "description": "Air pressure mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Water pressure mattress", "description": "Water pressure mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0187", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Synthetic sheepskin pad", "description": "Synthetic sheepskin pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0188", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lambswool sheepskin pad, any size", "description": "Lambswool sheepskin pad, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0189", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories", "description": "Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel or elbow protector, each", "description": "Heel or elbow protector, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0191", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Powered air flotation bed (low air loss therapy)", "description": "Powered air flotation bed (low air loss therapy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0193", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Air fluidized bed", "description": "Air fluidized bed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0194", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gel pressure mattress", "description": "Gel pressure mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0196", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Air pressure pad for mattress, standard mattress length and width", "description": "Air pressure pad for mattress, standard mattress length and width", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0197", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Water pressure pad for mattress, standard mattress length and width", "description": "Water pressure pad for mattress, standard mattress length and width", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0198", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dry pressure pad for mattress, standard mattress length and width", "description": "Dry pressure pad for mattress, standard mattress length and width", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heat lamp, without stand (table model), includes bulb, or infrared element", "description": "Heat lamp, without stand (table model), includes bulb, or infrared element", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Phototherapy (bilirubin) light with photometer", "description": "Phototherapy (bilirubin) light with photometer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic lightbox, minimum 10,000 lux, table top model", "description": "Therapeutic lightbox, minimum 10,000 lux, table top model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heat lamp, with stand, includes bulb, or infrared element", "description": "Heat lamp, with stand, includes bulb, or infrared element", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electric heat pad, standard", "description": "Electric heat pad, standard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electric heat pad, moist", "description": "Electric heat pad, moist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Water circulating heat pad with pump", "description": "Water circulating heat pad with pump", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0217", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fluid circulating cold pad with pump, any type", "description": "Fluid circulating cold pad with pump, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0218", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infrared heating pad system", "description": "Infrared heating pad system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocollator unit, includes pads", "description": "Hydrocollator unit, includes pads", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-contact wound warming device (temperature control unit, ac adapter and power cord) for use with warming card and wound cover", "description": "Non-contact wound warming device (temperature control unit, ac adapter and power cord) for use with warming card and wound cover", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0231", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Warming card for use with the non contact wound warming device and non contact wound warming wound cover", "description": "Warming card for use with the non contact wound warming device and non contact wound warming wound cover", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0232", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Paraffin bath unit, portable (see medical supply code a4265 for paraffin)", "description": "Paraffin bath unit, portable (see medical supply code a4265 for paraffin)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0235", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pump for water circulating pad", "description": "Pump for water circulating pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0236", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydrocollator unit, portable", "description": "Hydrocollator unit, portable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0239", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bath/shower chair, with or without wheels, any size", "description": "Bath/shower chair, with or without wheels, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bath tub wall rail, each", "description": "Bath tub wall rail, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0241", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bath tub rail, floor base", "description": "Bath tub rail, floor base", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0242", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Toilet rail, each", "description": "Toilet rail, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0243", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Raised toilet seat", "description": "Raised toilet seat", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0244", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tub stool or bench", "description": "Tub stool or bench", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer tub rail attachment", "description": "Transfer tub rail attachment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer bench for tub or toilet with or without commode opening", "description": "Transfer bench for tub or toilet with or without commode opening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer bench, heavy duty, for tub or toilet with or without commode opening", "description": "Transfer bench, heavy duty, for tub or toilet with or without commode opening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pad for water circulating heat unit, for replacement only", "description": "Pad for water circulating heat unit, for replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0249", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, fixed height, with any type side rails, with mattress", "description": "Hospital bed, fixed height, with any type side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, fixed height, with any type side rails, without mattress", "description": "Hospital bed, fixed height, with any type side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0251", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, variable height, hi-lo, with any type side rails, with mattress", "description": "Hospital bed, variable height, hi-lo, with any type side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, variable height, hi-lo, with any type side rails, without mattress", "description": "Hospital bed, variable height, hi-lo, with any type side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0256", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress", "description": "Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress", "description": "Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0261", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress", "description": "Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress", "description": "Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0266", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, institutional type includes: oscillating, circulating and stryker frame, with mattress", "description": "Hospital bed, institutional type includes: oscillating, circulating and stryker frame, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mattress, innerspring", "description": "Mattress, innerspring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0271", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mattress, foam rubber", "description": "Mattress, foam rubber", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0272", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bed board", "description": "Bed board", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0273", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Over-bed table", "description": "Over-bed table", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0274", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bed pan, standard, metal or plastic", "description": "Bed pan, standard, metal or plastic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bed pan, fracture, metal or plastic", "description": "Bed pan, fracture, metal or plastic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0276", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Powered pressure-reducing air mattress", "description": "Powered pressure-reducing air mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0277", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bed cradle, any type", "description": "Bed cradle, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, fixed height, without side rails, with mattress", "description": "Hospital bed, fixed height, without side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, fixed height, without side rails, without mattress", "description": "Hospital bed, fixed height, without side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0291", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, variable height, hi-lo, without side rails, with mattress", "description": "Hospital bed, variable height, hi-lo, without side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0292", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, variable height, hi-lo, without side rails, without mattress", "description": "Hospital bed, variable height, hi-lo, without side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0293", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress", "description": "Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0294", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress", "description": "Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0295", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress", "description": "Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0296", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress", "description": "Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0297", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediatric crib, hospital grade, fully enclosed, with or without top enclosure", "description": "Pediatric crib, hospital grade, fully enclosed, with or without top enclosure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress", "description": "Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress", "description": "Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0302", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress", "description": "Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0303", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress", "description": "Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0304", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bed side rails, half length", "description": "Bed side rails, half length", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0305", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bed side rails, full length", "description": "Bed side rails, full length", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bed accessory: board, table, or support device, any type", "description": "Bed accessory: board, table, or support device, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Safety enclosure frame/canopy for use with hospital bed, any type", "description": "Safety enclosure frame/canopy for use with hospital bed, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0316", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urinal; male, jug-type, any material", "description": "Urinal; male, jug-type, any material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urinal; female, jug-type, any material", "description": "Urinal; female, jug-type, any material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0326", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress", "description": "Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0328", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital bed, pediatric, electric or semi-electric, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress", "description": "Hospital bed, pediatric, electric or semi-electric, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0329", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Control unit for electronic bowel irrigation/evacuation system", "description": "Control unit for electronic bowel irrigation/evacuation system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable pack (water reservoir bag, speculum, valving mechanism and collection bag/box) for use with the electronic bowel irrigation/evacuation system", "description": "Disposable pack (water reservoir bag, speculum, valving mechanism and collection bag/box) for use with the electronic bowel irrigation/evacuation system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0352", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Air pressure elevator for heel", "description": "Air pressure elevator for heel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width", "description": "Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0371", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Powered air overlay for mattress, standard mattress length and width", "description": "Powered air overlay for mattress, standard mattress length and width", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0372", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nonpowered advanced pressure reducing mattress", "description": "Nonpowered advanced pressure reducing mattress", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0373", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing", "description": "Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0424", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing", "description": "Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0425", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing", "description": "Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing", "description": "Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0431", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge", "description": "Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0433", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing", "description": "Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0434", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor", "description": "Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0435", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing", "description": "Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0439", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing", "description": "Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0440", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stationary oxygen contents, gaseous, 1 month's supply = 1 unit", "description": "Stationary oxygen contents, gaseous, 1 month's supply = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0441", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stationary oxygen contents, liquid, 1 month's supply = 1 unit", "description": "Stationary oxygen contents, liquid, 1 month's supply = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0442", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable oxygen contents, gaseous, 1 month's supply = 1 unit", "description": "Portable oxygen contents, gaseous, 1 month's supply = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0443", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable oxygen contents, liquid, 1 month's supply = 1 unit", "description": "Portable oxygen contents, liquid, 1 month's supply = 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0444", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oximeter device for measuring blood oxygen levels non-invasively", "description": "Oximeter device for measuring blood oxygen levels non-invasively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0445", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories", "description": "Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0446", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable oxygen contents, liquid, 1 month's supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)", "description": "Portable oxygen contents, liquid, 1 month's supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0447", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Volume control ventilator, without pressure support mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube)", "description": "Volume control ventilator, without pressure support mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen tent, excluding croup or pediatric tents", "description": "Oxygen tent, excluding croup or pediatric tents", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chest shell (cuirass)", "description": "Chest shell (cuirass)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0457", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chest wrap", "description": "Chest wrap", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0459", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Negative pressure ventilator; portable or stationary", "description": "Negative pressure ventilator; portable or stationary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Volume control ventilator, without pressure support mode, may include pressure control mode, used with non-invasive interface (e.g., mask)", "description": "Volume control ventilator, without pressure support mode, may include pressure control mode, used with non-invasive interface (e.g., mask)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0461", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rocking bed with or without side rails", "description": "Rocking bed with or without side rails", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0462", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pressure support ventilator with volume control mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube)", "description": "Pressure support ventilator with volume control mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0463", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pressure support ventilator with volume control mode, may include pressure control mode, used with non-invasive interface (e.g., mask)", "description": "Pressure support ventilator with volume control mode, may include pressure control mode, used with non-invasive interface (e.g., mask)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0464", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)", "description": "Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)", "description": "Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0466", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions", "description": "Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0467", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)", "description": "Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)", "description": "Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0471", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)", "description": "Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0472", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percussor, electric or pneumatic, home model", "description": "Percussor, electric or pneumatic, home model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intrapulmonary percussive ventilation system and related accessories", "description": "Intrapulmonary percussive ventilation system and related accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0481", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cough stimulating device, alternating positive and negative airway pressure", "description": "Cough stimulating device, alternating positive and negative airway pressure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0482", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High frequency chest wall oscillation system, includes all accessories and supplies, each", "description": "High frequency chest wall oscillation system, includes all accessories and supplies, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0483", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oscillatory positive expiratory pressure device, non-electric, any type, each", "description": "Oscillatory positive expiratory pressure device, non-electric, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0484", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment", "description": "Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment", "description": "Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0486", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spirometer, electronic, includes all accessories", "description": "Spirometer, electronic, includes all accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0487", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source", "description": "Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery", "description": "Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter", "description": "Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0555", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery", "description": "Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Humidifier, non-heated, used with positive airway pressure device", "description": "Humidifier, non-heated, used with positive airway pressure device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0561", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Humidifier, heated, used with positive airway pressure device", "description": "Humidifier, heated, used with positive airway pressure device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compressor, air power source for equipment which is not self-contained or cylinder driven", "description": "Compressor, air power source for equipment which is not self-contained or cylinder driven", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0565", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nebulizer, with compressor", "description": "Nebulizer, with compressor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aerosol compressor, adjustable pressure, light duty for intermittent use", "description": "Aerosol compressor, adjustable pressure, light duty for intermittent use", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0572", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultrasonic/electronic aerosol generator with small volume nebulizer", "description": "Ultrasonic/electronic aerosol generator with small volume nebulizer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0574", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nebulizer, ultrasonic, large volume", "description": "Nebulizer, ultrasonic, large volume", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0575", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter", "description": "Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nebulizer, with compressor and heater", "description": "Nebulizer, with compressor and heater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0585", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Respiratory suction pump, home model, portable or stationary, electric", "description": "Respiratory suction pump, home model, portable or stationary, electric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Continuous positive airway pressure (cpap) device", "description": "Continuous positive airway pressure (cpap) device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0601", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast pump, manual, any type", "description": "Breast pump, manual, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0602", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast pump, electric (ac and/or dc), any type", "description": "Breast pump, electric (ac and/or dc), any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0603", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast pump, hospital grade, electric (ac and / or dc), any type", "description": "Breast pump, hospital grade, electric (ac and / or dc), any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vaporizer, room type", "description": "Vaporizer, room type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0605", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Postural drainage board", "description": "Postural drainage board", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home blood glucose monitor", "description": "Home blood glucose monitor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0607", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)", "description": "Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems", "description": "Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable cardiac event recorder with memory, activator and programmer", "description": "Implantable cardiac event recorder with memory, activator and programmer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0616", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External defibrillator with integrated electrocardiogram analysis", "description": "External defibrillator with integrated electrocardiogram analysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0617", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Apnea monitor, without recording feature", "description": "Apnea monitor, without recording feature", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0618", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Apnea monitor, with recording feature", "description": "Apnea monitor, with recording feature", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0619", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin piercing device for collection of capillary blood, laser, each", "description": "Skin piercing device for collection of capillary blood, laser, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sling or seat, patient lift, canvas or nylon", "description": "Sling or seat, patient lift, canvas or nylon", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0621", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient lift, bathroom or toilet, not otherwise classified", "description": "Patient lift, bathroom or toilet, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Seat lift mechanism, electric, any type", "description": "Seat lift mechanism, electric, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Separate seat lift mechanism for use with patient owned furniture-electric", "description": "Separate seat lift mechanism for use with patient owned furniture-electric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Seat lift mechanism, non-electric, any type", "description": "Seat lift mechanism, non-electric, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)", "description": "Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient lift, electric with seat or sling", "description": "Patient lift, electric with seat or sling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Multipositional patient support system, with integrated lift, patient accessible controls", "description": "Multipositional patient support system, with integrated lift, patient accessible controls", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels", "description": "Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels", "description": "Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories", "description": "Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0639", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient lift, fixed system, includes all components/accessories", "description": "Patient lift, fixed system, includes all components/accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels", "description": "Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standing frame/table system, mobile (dynamic stander), any size including pediatric", "description": "Standing frame/table system, mobile (dynamic stander), any size including pediatric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumatic compressor, non-segmental home model", "description": "Pneumatic compressor, non-segmental home model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumatic compressor, segmental home model without calibrated gradient pressure", "description": "Pneumatic compressor, segmental home model without calibrated gradient pressure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0651", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumatic compressor, segmental home model with calibrated gradient pressure", "description": "Pneumatic compressor, segmental home model with calibrated gradient pressure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0652", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-segmental pneumatic appliance for use with pneumatic compressor, half arm", "description": "Non-segmental pneumatic appliance for use with pneumatic compressor, half arm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0655", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental pneumatic appliance for use with pneumatic compressor, trunk", "description": "Segmental pneumatic appliance for use with pneumatic compressor, trunk", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0656", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental pneumatic appliance for use with pneumatic compressor, chest", "description": "Segmental pneumatic appliance for use with pneumatic compressor, chest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0657", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-segmental pneumatic appliance for use with pneumatic compressor, full leg", "description": "Non-segmental pneumatic appliance for use with pneumatic compressor, full leg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-segmental pneumatic appliance for use with pneumatic compressor, full arm", "description": "Non-segmental pneumatic appliance for use with pneumatic compressor, full arm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0665", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-segmental pneumatic appliance for use with pneumatic compressor, half leg", "description": "Non-segmental pneumatic appliance for use with pneumatic compressor, half leg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0666", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental pneumatic appliance for use with pneumatic compressor, full leg", "description": "Segmental pneumatic appliance for use with pneumatic compressor, full leg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0667", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental pneumatic appliance for use with pneumatic compressor, full arm", "description": "Segmental pneumatic appliance for use with pneumatic compressor, full arm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0668", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental pneumatic appliance for use with pneumatic compressor, half leg", "description": "Segmental pneumatic appliance for use with pneumatic compressor, half leg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0669", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk", "description": "Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental gradient pressure pneumatic appliance, full leg", "description": "Segmental gradient pressure pneumatic appliance, full leg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0671", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental gradient pressure pneumatic appliance, full arm", "description": "Segmental gradient pressure pneumatic appliance, full arm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0672", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segmental gradient pressure pneumatic appliance, half leg", "description": "Segmental gradient pressure pneumatic appliance, half leg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0673", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)", "description": "Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0675", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intermittent limb compression device (includes all accessories), not otherwise specified", "description": "Intermittent limb compression device (includes all accessories), not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0676", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less", "description": "Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0691", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel", "description": "Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0692", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel", "description": "Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0693", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection", "description": "Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0694", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Safety equipment, device or accessory, any type", "description": "Safety equipment, device or accessory, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer device, any type, each", "description": "Transfer device, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0705", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Restraints, any type (body, chest, wrist or ankle)", "description": "Restraints, any type (body, chest, wrist or ankle)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation", "description": "Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation", "description": "Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric)", "description": "Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0731", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-implanted pelvic floor electrical stimulator, complete system", "description": "Non-implanted pelvic floor electrical stimulator, complete system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Neuromuscular stimulator for scoliosis", "description": "Neuromuscular stimulator for scoliosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0744", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Neuromuscular stimulator, electronic shock unit", "description": "Neuromuscular stimulator, electronic shock unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0745", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electromyography (emg), biofeedback device", "description": "Electromyography (emg), biofeedback device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0746", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Osteogenesis stimulator, electrical, non-invasive, other than spinal applications", "description": "Osteogenesis stimulator, electrical, non-invasive, other than spinal applications", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0747", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Osteogenesis stimulator, electrical, non-invasive, spinal applications", "description": "Osteogenesis stimulator, electrical, non-invasive, spinal applications", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0748", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Osteogenesis stimulator, electrical, surgically implanted", "description": "Osteogenesis stimulator, electrical, surgically implanted", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0749", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic salivary reflex stimulator (intra-oral/non-invasive)", "description": "Electronic salivary reflex stimulator (intra-oral/non-invasive)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0755", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Osteogenesis stimulator, low intensity ultrasound, non-invasive", "description": "Osteogenesis stimulator, low intensity ultrasound, non-invasive", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device", "description": "Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0761", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcutaneous electrical joint stimulation device system, includes all accessories", "description": "Transcutaneous electrical joint stimulation device system, includes all accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0762", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program", "description": "Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0764", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fda approved nerve stimulator, with replaceable batteries, for treatment of nausea and vomiting", "description": "Fda approved nerve stimulator, with replaceable batteries, for treatment of nausea and vomiting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0765", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrical stimulation device used for cancer treatment, includes all accessories, any type", "description": "Electrical stimulation device used for cancer treatment, includes all accessories, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0766", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrical stimulation or electromagnetic wound treatment device, not otherwise classified", "description": "Electrical stimulation or electromagnetic wound treatment device, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0769", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional electrical stimulator, transcutaneous stimulation of nerve and/or muscle groups, any type, complete system, not otherwise specified", "description": "Functional electrical stimulator, transcutaneous stimulation of nerve and/or muscle groups, any type, complete system, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iv pole", "description": "Iv pole", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0776", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater", "description": "Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0779", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours", "description": "Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient", "description": "Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0781", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)", "description": "Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0782", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)", "description": "Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0783", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External ambulatory infusion pump, insulin", "description": "External ambulatory infusion pump, insulin", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0784", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement", "description": "Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0785", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)", "description": "Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0786", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing", "description": "External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0787", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenteral infusion pump, stationary, single or multi-channel", "description": "Parenteral infusion pump, stationary, single or multi-channel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0791", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulatory traction device, all types, each", "description": "Ambulatory traction device, all types, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Traction frame, attached to headboard, cervical traction", "description": "Traction frame, attached to headboard, cervical traction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible", "description": "Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0849", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Traction stand, free standing, cervical traction", "description": "Traction stand, free standing, cervical traction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical traction equipment not requiring additional stand or frame", "description": "Cervical traction equipment not requiring additional stand or frame", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0855", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical traction device, with inflatable air bladder(s)", "description": "Cervical traction device, with inflatable air bladder(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0856", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Traction equipment, overdoor, cervical", "description": "Traction equipment, overdoor, cervical", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0860", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Traction frame, attached to footboard, extremity traction, (e.g., buck's)", "description": "Traction frame, attached to footboard, extremity traction, (e.g., buck's)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0870", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Traction stand, free standing, extremity traction", "description": "Traction stand, free standing, extremity traction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0880", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Traction frame, attached to footboard, pelvic traction", "description": "Traction frame, attached to footboard, pelvic traction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Traction stand, free standing, pelvic traction, (e.g., buck's)", "description": "Traction stand, free standing, pelvic traction, (e.g., buck's)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trapeze bars, a/k/a patient helper, attached to bed, with grab bar", "description": "Trapeze bars, a/k/a patient helper, attached to bed, with grab bar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar", "description": "Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0911", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar", "description": "Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0912", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fracture frame, attached to bed, includes weights", "description": "Fracture frame, attached to bed, includes weights", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0920", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fracture frame, free standing, includes weights", "description": "Fracture frame, free standing, includes weights", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Continuous passive motion exercise device for use on knee only", "description": "Continuous passive motion exercise device for use on knee only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0935", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Continuous passive motion exercise device for use other than knee", "description": "Continuous passive motion exercise device for use other than knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0936", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trapeze bar, free standing, complete with grab bar", "description": "Trapeze bar, free standing, complete with grab bar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gravity assisted traction device, any type", "description": "Gravity assisted traction device, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0941", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical head harness/halter", "description": "Cervical head harness/halter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0942", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pelvic belt/harness/boot", "description": "Pelvic belt/harness/boot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0944", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extremity belt/harness", "description": "Extremity belt/harness", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0945", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)", "description": "Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0946", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fracture frame, attachments for complex pelvic traction", "description": "Fracture frame, attachments for complex pelvic traction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0947", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fracture frame, attachments for complex cervical traction", "description": "Fracture frame, attachments for complex cervical traction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0948", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, tray, each", "description": "Wheelchair accessory, tray, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel loop/holder, any type, with or without ankle strap, each", "description": "Heel loop/holder, any type, with or without ankle strap, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0951", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Toe loop/holder, any type, each", "description": "Toe loop/holder, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0952", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each", "description": "Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0953", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot", "description": "Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0954", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each", "description": "Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0955", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each", "description": "Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0956", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each", "description": "Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0957", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, one-arm drive attachment, each", "description": "Manual wheelchair accessory, one-arm drive attachment, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0958", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, adapter for amputee, each", "description": "Manual wheelchair accessory, adapter for amputee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0959", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware", "description": "Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, wheel lock brake extension (handle), each", "description": "Manual wheelchair accessory, wheel lock brake extension (handle), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0961", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, headrest extension, each", "description": "Manual wheelchair accessory, headrest extension, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0966", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, hand rim with projections, any type, replacement only, each", "description": "Manual wheelchair accessory, hand rim with projections, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0967", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Commode seat, wheelchair", "description": "Commode seat, wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0968", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Narrowing device, wheelchair", "description": "Narrowing device, wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0969", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No. 2 footplates, except for elevating leg rest", "description": "No. 2 footplates, except for elevating leg rest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, anti-tipping device, each", "description": "Manual wheelchair accessory, anti-tipping device, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0971", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each", "description": "Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0973", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, anti-rollback device, each", "description": "Manual wheelchair accessory, anti-rollback device, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0974", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, positioning belt/safety belt/pelvic strap, each", "description": "Wheelchair accessory, positioning belt/safety belt/pelvic strap, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0978", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Safety vest, wheelchair", "description": "Safety vest, wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, seat upholstery, replacement only, each", "description": "Wheelchair accessory, seat upholstery, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0981", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, back upholstery, replacement only, each", "description": "Wheelchair accessory, back upholstery, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control", "description": "Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0983", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control", "description": "Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0984", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, seat lift mechanism", "description": "Wheelchair accessory, seat lift mechanism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0985", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, push-rim activated power assist system", "description": "Manual wheelchair accessory, push-rim activated power assist system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0986", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, lever-activated, wheel drive, pair", "description": "Manual wheelchair accessory, lever-activated, wheel drive, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0988", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, elevating leg rest, complete assembly, each", "description": "Wheelchair accessory, elevating leg rest, complete assembly, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0990", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, solid seat insert", "description": "Manual wheelchair accessory, solid seat insert", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0992", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Arm rest, each", "description": "Arm rest, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0994", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, calf rest/pad, replacement only, each", "description": "Wheelchair accessory, calf rest/pad, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0995", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power seating system, tilt only", "description": "Wheelchair accessory, power seating system, tilt only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power seating system, recline only, without shear reduction", "description": "Wheelchair accessory, power seating system, recline only, without shear reduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power seating system, recline only, with mechanical shear reduction", "description": "Wheelchair accessory, power seating system, recline only, with mechanical shear reduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power seatng system, recline only, with power shear reduction", "description": "Wheelchair accessory, power seatng system, recline only, with power shear reduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction", "description": "Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction", "description": "Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction", "description": "Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each", "description": "Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair", "description": "Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)", "description": "Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each", "description": "Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reclining back, addition to pediatric size wheelchair", "description": "Reclining back, addition to pediatric size wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shock absorber for manual wheelchair, each", "description": "Shock absorber for manual wheelchair, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shock absorber for power wheelchair, each", "description": "Shock absorber for power wheelchair, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each", "description": "Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each", "description": "Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Residual limb support system for wheelchair, any type", "description": "Residual limb support system for wheelchair, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory", "description": "Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, ventilator tray, fixed", "description": "Wheelchair accessory, ventilator tray, fixed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, ventilator tray, gimbaled", "description": "Wheelchair accessory, ventilator tray, gimbaled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rollabout chair, any and all types with casters 5\" or greater", "description": "Rollabout chair, any and all types with casters 5\" or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs", "description": "Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs", "description": "Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transport chair, pediatric size", "description": "Transport chair, pediatric size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transport chair, adult size, patient weight capacity up to and including 300 pounds", "description": "Transport chair, adult size, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds", "description": "Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests", "description": "Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests", "description": "Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest", "description": "Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest", "description": "Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests", "description": "Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1084", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemi-wheelchair, fixed full length arms, swing away detachable foot rests", "description": "Hemi-wheelchair, fixed full length arms, swing away detachable foot rests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1085", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests", "description": "Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1086", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests", "description": "High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1087", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests", "description": "High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1088", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High strength lightweight wheelchair, fixed length arms, swing away detachable footrest", "description": "High strength lightweight wheelchair, fixed length arms, swing away detachable footrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1089", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable foot rests", "description": "High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable foot rests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests", "description": "Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1092", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests", "description": "Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1093", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests", "description": "Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest", "description": "Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests", "description": "Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, detachable arms, desk or full length, swing away detachable footrests", "description": "Wheelchair, detachable arms, desk or full length, swing away detachable footrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests", "description": "Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, fixed full length arms, swing away detachable elevating legrests", "description": "Wheelchair, fixed full length arms, swing away detachable elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual adult size wheelchair, includes tilt in space", "description": "Manual adult size wheelchair, includes tilt in space", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests", "description": "Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amputee wheelchair, fixed full length arms, without footrests or legrest", "description": "Amputee wheelchair, fixed full length arms, without footrests or legrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest", "description": "Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1172", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests", "description": "Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests", "description": "Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests", "description": "Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1195", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amputee wheelchair, fixed full length arms, swing away detachable footrest", "description": "Amputee wheelchair, fixed full length arms, swing away detachable footrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification", "description": "Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair with fixed arm, footrests", "description": "Wheelchair with fixed arm, footrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair with fixed arm, elevating legrests", "description": "Wheelchair with fixed arm, elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair with detachable arms, footrests", "description": "Wheelchair with detachable arms, footrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1223", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair with detachable arms, elevating legrests", "description": "Wheelchair with detachable arms, elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1224", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each", "description": "Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each", "description": "Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1226", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Special height arms for wheelchair", "description": "Special height arms for wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1227", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Special back height for wheelchair", "description": "Special back height for wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1228", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, not otherwise specified", "description": "Wheelchair, pediatric size, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1229", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power operated vehicle (three or four wheel nonhighway) specify brand name and model number", "description": "Power operated vehicle (three or four wheel nonhighway) specify brand name and model number", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system", "description": "Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1231", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system", "description": "Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1232", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system", "description": "Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1233", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system", "description": "Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1234", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, rigid, adjustable, with seating system", "description": "Wheelchair, pediatric size, rigid, adjustable, with seating system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1235", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, folding, adjustable, with seating system", "description": "Wheelchair, pediatric size, folding, adjustable, with seating system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1236", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, rigid, adjustable, without seating system", "description": "Wheelchair, pediatric size, rigid, adjustable, without seating system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1237", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair, pediatric size, folding, adjustable, without seating system", "description": "Wheelchair, pediatric size, folding, adjustable, without seating system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1238", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, pediatric size, not otherwise specified", "description": "Power wheelchair, pediatric size, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1239", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest", "description": "Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lightweight wheelchair, fixed full length arms, swing away detachable footrest", "description": "Lightweight wheelchair, fixed full length arms, swing away detachable footrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest", "description": "Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests", "description": "Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests", "description": "Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heavy duty wheelchair, fixed full length arms, swing away detachable footrest", "description": "Heavy duty wheelchair, fixed full length arms, swing away detachable footrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest", "description": "Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heavy duty wheelchair, fixed full length arms, elevating legrest", "description": "Heavy duty wheelchair, fixed full length arms, elevating legrest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1295", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Special wheelchair seat height from floor", "description": "Special wheelchair seat height from floor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1296", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Special wheelchair seat depth, by upholstery", "description": "Special wheelchair seat depth, by upholstery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1297", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Special wheelchair seat depth and/or width, by construction", "description": "Special wheelchair seat depth and/or width, by construction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1298", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Whirlpool, portable (overtub type)", "description": "Whirlpool, portable (overtub type)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Whirlpool, non-portable (built-in type)", "description": "Whirlpool, non-portable (built-in type)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen accessory, flow regulator capable of positive inspiratory pressure", "description": "Oxygen accessory, flow regulator capable of positive inspiratory pressure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1352", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Regulator", "description": "Regulator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1353", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each", "description": "Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1354", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stand/rack", "description": "Stand/rack", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1355", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each", "description": "Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1356", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each", "description": "Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1357", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each", "description": "Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1358", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immersion external heater for nebulizer", "description": "Immersion external heater for nebulizer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1372", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate", "description": "Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each", "description": "Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1391", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable oxygen concentrator, rental", "description": "Portable oxygen concentrator, rental", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1392", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Durable medical equipment, miscellaneous", "description": "Durable medical equipment, miscellaneous", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1399", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen and water vapor enriching system with heated delivery", "description": "Oxygen and water vapor enriching system with heated delivery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1405", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen and water vapor enriching system without heated delivery", "description": "Oxygen and water vapor enriching system without heated delivery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1406", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Centrifuge, for dialysis", "description": "Centrifuge, for dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Kidney, dialysate delivery syst kidney machine, pump recirculating, air removal syst, flowrate meter, power off, heater and temperature control with alarm, i.v. poles, pressure gauge, concentrate container", "description": "Kidney, dialysate delivery syst kidney machine, pump recirculating, air removal syst, flowrate meter, power off, heater and temperature control with alarm, i.v. poles, pressure gauge, concentrate container", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heparin infusion pump for hemodialysis", "description": "Heparin infusion pump for hemodialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Air bubble detector for hemodialysis, each, replacement", "description": "Air bubble detector for hemodialysis, each, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pressure alarm for hemodialysis, each, replacement", "description": "Pressure alarm for hemodialysis, each, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bath conductivity meter for hemodialysis, each", "description": "Bath conductivity meter for hemodialysis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood leak detector for hemodialysis, each, replacement", "description": "Blood leak detector for hemodialysis, each, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adjustable chair, for esrd patients", "description": "Adjustable chair, for esrd patients", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transducer protectors/fluid barriers, for hemodialysis, any size, per 10", "description": "Transducer protectors/fluid barriers, for hemodialysis, any size, per 10", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1575", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unipuncture control system for hemodialysis", "description": "Unipuncture control system for hemodialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemodialysis machine", "description": "Hemodialysis machine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Automatic intermittent peritoneal dialysis system", "description": "Automatic intermittent peritoneal dialysis system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1592", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cycler dialysis machine for peritoneal dialysis", "description": "Cycler dialysis machine for peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1594", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Delivery and/or installation charges for hemodialysis equipment", "description": "Delivery and/or installation charges for hemodialysis equipment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reverse osmosis water purification system, for hemodialysis", "description": "Reverse osmosis water purification system, for hemodialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Deionizer water purification system, for hemodialysis", "description": "Deionizer water purification system, for hemodialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood pump for hemodialysis, replacement", "description": "Blood pump for hemodialysis, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Water softening system, for hemodialysis", "description": "Water softening system, for hemodialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reciprocating peritoneal dialysis system", "description": "Reciprocating peritoneal dialysis system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wearable artificial kidney, each", "description": "Wearable artificial kidney, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Peritoneal dialysis clamps, each", "description": "Peritoneal dialysis clamps, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1634", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compact (portable) travel hemodialyzer system", "description": "Compact (portable) travel hemodialyzer system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sorbent cartridges, for hemodialysis, per 10", "description": "Sorbent cartridges, for hemodialysis, per 10", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemostats, each", "description": "Hemostats, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Scale, each", "description": "Scale, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1639", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysis equipment, not otherwise specified", "description": "Dialysis equipment, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Jaw motion rehabilitation system", "description": "Jaw motion rehabilitation system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement cushions for jaw motion rehabilitation system, pkg. of 6", "description": "Replacement cushions for jaw motion rehabilitation system, pkg. of 6", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1701", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200", "description": "Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1702", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic adjustable elbow extension/flexion device, includes soft interface material", "description": "Dynamic adjustable elbow extension/flexion device, includes soft interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static progressive stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories", "description": "Static progressive stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1801", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic adjustable forearm pronation/supination device, includes soft interface material", "description": "Dynamic adjustable forearm pronation/supination device, includes soft interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1802", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic adjustable wrist extension / flexion device, includes soft interface material", "description": "Dynamic adjustable wrist extension / flexion device, includes soft interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1805", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories", "description": "Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1806", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic adjustable knee extension / flexion device, includes soft interface material", "description": "Dynamic adjustable knee extension / flexion device, includes soft interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static progressive stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories", "description": "Static progressive stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1811", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic knee, extension/flexion device with active resistance control", "description": "Dynamic knee, extension/flexion device with active resistance control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1812", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic adjustable ankle extension/flexion device, includes soft interface material", "description": "Dynamic adjustable ankle extension/flexion device, includes soft interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1815", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories", "description": "Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1816", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static progressive stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories", "description": "Static progressive stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1818", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement soft interface material, dynamic adjustable extension/flexion device", "description": "Replacement soft interface material, dynamic adjustable extension/flexion device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1820", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement soft interface material/cuffs for bi-directional static progressive stretch device", "description": "Replacement soft interface material/cuffs for bi-directional static progressive stretch device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1821", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic adjustable finger extension/flexion device, includes soft interface material", "description": "Dynamic adjustable finger extension/flexion device, includes soft interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1825", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic adjustable toe extension/flexion device, includes soft interface material", "description": "Dynamic adjustable toe extension/flexion device, includes soft interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories", "description": "Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1831", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material", "description": "Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static progressive stretch shoulder device, with or without range of motion adjustment, includes all components and accessories", "description": "Static progressive stretch shoulder device, with or without range of motion adjustment, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1841", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Communication board, non-electronic augmentative or alternative communication device", "description": "Communication board, non-electronic augmentative or alternative communication device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1902", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gastric suction pump, home model, 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"expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood glucose monitor with integrated lancing/blood sample", "description": "Blood glucose monitor with integrated lancing/blood sample", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pulse generator system for tympanic treatment of inner ear endolymphatic fluid", "description": "Pulse generator system for tympanic treatment of inner ear endolymphatic fluid", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches", "description": "Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches", "description": "Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches", "description": "Manual wheelchair 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"expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each", "description": "Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, wheel lock 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"negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, cylinder tank carrier, each", "description": "Wheelchair accessory, cylinder tank carrier, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Accessory, arm trough, with or without hand support, each", "description": "Accessory, arm trough, with or without hand support, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, bearings, any type, replacement only, each", "description": "Wheelchair accessory, bearings, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, pneumatic propulsion tire, any size, each", "description": "Manual wheelchair accessory, pneumatic propulsion tire, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each", "description": "Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each", "description": "Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, pneumatic caster tire, any size, each", "description": "Manual wheelchair accessory, pneumatic caster tire, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, tube for pneumatic caster tire, any size, each", "description": "Manual wheelchair accessory, tube for pneumatic caster tire, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, foam filled propulsion tire, any size, each", "description": "Manual wheelchair accessory, foam filled propulsion tire, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, foam filled caster tire, any size, each", "description": "Manual wheelchair accessory, foam filled caster tire, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2217", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, foam propulsion tire, any size, each", "description": "Manual wheelchair accessory, foam propulsion tire, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2218", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, foam caster tire, any size, each", "description": "Manual wheelchair accessory, foam caster tire, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2219", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each", "description": "Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each", "description": "Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each", "description": "Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each", "description": "Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2224", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each", "description": "Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, caster fork, any size, replacement only, each", "description": "Manual wheelchair accessory, caster fork, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2226", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, gear reduction drive wheel, each", "description": "Manual wheelchair accessory, gear reduction drive wheel, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2227", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, wheel braking system and lock, complete, each", "description": "Manual wheelchair accessory, wheel braking system and lock, complete, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2228", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, manual standing system", "description": "Manual wheelchair accessory, manual standing system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware", "description": "Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2231", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back, planar, for pediatric size wheelchair including fixed attaching hardware", "description": "Back, planar, for pediatric size wheelchair including fixed attaching hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2291", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Seat, planar, for pediatric size wheelchair including fixed attaching hardware", "description": "Seat, planar, for pediatric size wheelchair including fixed attaching hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2292", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back, contoured, for pediatric size wheelchair including fixed attaching hardware", "description": "Back, contoured, for pediatric size wheelchair including fixed attaching hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2293", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Seat, contoured, for pediatric size wheelchair including fixed attaching hardware", "description": "Seat, contoured, for pediatric size wheelchair including fixed attaching hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2294", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Manual wheelchair accessory, for pediatric size wheelchair, dynamic seating frame, allows coordinated movement of multiple positioning features", "description": "Manual wheelchair accessory, for pediatric size wheelchair, dynamic seating frame, allows coordinated movement of multiple positioning features", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2295", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power seat elevation system, any type", "description": "Wheelchair accessory, power seat elevation system, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, power standing system, any type", "description": "Wheelchair accessory, power standing system, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware", "description": "Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware", "description": "Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2311", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware", "description": "Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2312", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each", "description": "Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2313", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware", "description": "Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2321", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware", "description": "Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2322", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated", "description": "Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2323", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, chin cup for chin control interface", "description": "Power wheelchair accessory, chin cup for chin control interface", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2324", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware", "description": "Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, breath tube kit for sip and puff interface", "description": "Power wheelchair accessory, breath tube kit for sip and puff interface", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2326", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware", "description": "Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2327", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware", "description": "Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2328", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware", "description": "Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2329", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware", "description": "Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, attendant control, proportional, including all related electronics and fixed mounting hardware", "description": "Power wheelchair accessory, attendant control, proportional, including all related electronics and fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2331", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, nonstandard seat frame width, 20-23 inches", "description": "Power wheelchair accessory, nonstandard seat frame width, 20-23 inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, nonstandard seat frame width, 24-27 inches", "description": "Power wheelchair accessory, nonstandard seat frame width, 24-27 inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2341", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches", "description": "Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2342", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches", "description": "Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2343", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface", "description": "Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2351", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, group 34 non-sealed lead acid battery, each", "description": "Power wheelchair accessory, group 34 non-sealed lead acid battery, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2358", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)", "description": "Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2359", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, 22nf non-sealed lead acid battery, each", "description": "Power wheelchair accessory, 22nf non-sealed lead acid battery, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)", "description": "Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2361", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, group 24 non-sealed lead acid battery, each", "description": "Power wheelchair accessory, group 24 non-sealed lead acid battery, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2362", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)", "description": "Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2363", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, u-1 non-sealed lead acid battery, each", "description": "Power wheelchair accessory, u-1 non-sealed lead acid battery, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)", "description": "Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2365", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each", "description": "Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2366", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each", "description": "Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2367", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair component, drive wheel motor, replacement only", "description": "Power wheelchair component, drive wheel motor, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2368", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair component, drive wheel gear box, replacement only", "description": "Power wheelchair component, drive wheel gear box, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2369", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only", "description": "Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each", "description": "Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2371", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, group 27 non-sealed lead acid battery, each", "description": "Power wheelchair accessory, group 27 non-sealed lead acid battery, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2372", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware", "description": "Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2373", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only", "description": "Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2374", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only", "description": "Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2375", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only", "description": "Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2376", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue", "description": "Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2377", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair component, actuator, replacement only", "description": "Power wheelchair component, actuator, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2378", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each", "description": "Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2381", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each", "description": "Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2382", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each", "description": "Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2383", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each", "description": "Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2384", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each", "description": "Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2385", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each", "description": "Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2386", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, foam filled caster tire, any size, replacement only, each", "description": "Power wheelchair accessory, foam filled caster tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2387", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each", "description": "Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2388", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, foam caster tire, any size, replacement only, each", "description": "Power wheelchair accessory, foam caster tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2389", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each", "description": "Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each", "description": "Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2391", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each", "description": "Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2392", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each", "description": "Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2394", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each", "description": "Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2395", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, caster fork, any size, replacement only, each", "description": "Power wheelchair accessory, caster fork, any size, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": 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"negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time", "description": "Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { 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"provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device", "description": "Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", 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"additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Accessory for speech generating device, not otherwise classified", "description": "Accessory for speech generating device, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2599", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "General use wheelchair seat cushion, width less than 22 inches, any depth", "description": "General use wheelchair seat cushion, width less than 22 inches, any depth", "negotiation_arrangement": 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[ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware", "description": "General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2611", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware", "description": "General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2612", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware", "description": "Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware", 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"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware", "description": "Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2616", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Custom fabricated wheelchair back cushion, any size, including any type mounting hardware", "description": "Custom fabricated wheelchair back cushion, any size, including any type mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2617", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement cover for wheelchair seat cushion or back cushion, each", "description": "Replacement cover for wheelchair seat cushion or back cushion, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2619", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware", "description": "Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware", "description": "Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2621", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth", "description": "Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth", "description": "Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2623", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth", "description": "Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth", "description": "Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable", "description": "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type", "description": "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining", "description": "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)", "description": "Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support", "description": "Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, addition to mobile arm support, elevating proximal arm", "description": "Wheelchair accessory, addition to mobile arm support, elevating proximal arm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control", "description": "Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, addition to mobile arm support, supinator", "description": "Wheelchair accessory, addition to mobile arm support, supinator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2633", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gait trainer, pediatric size, posterior support, includes all accessories and components", "description": "Gait trainer, pediatric size, posterior support, includes all accessories and components", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E8000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gait trainer, pediatric size, upright support, includes all accessories and components", "description": "Gait trainer, pediatric size, upright support, includes all accessories and components", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E8001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gait trainer, pediatric size, anterior support, includes all accessories and components", "description": "Gait trainer, pediatric size, anterior support, includes all accessories and components", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E8002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration of influenza virus vaccine", "description": "Administration of influenza virus vaccine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration of pneumococcal vaccine", "description": "Administration of pneumococcal vaccine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration of hepatitis b vaccine", "description": "Administration of hepatitis b vaccine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Semen analysis; presence and/or motility of sperm excluding huhner", "description": "Semen analysis; presence and/or motility of sperm excluding huhner", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes", "description": "Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0068", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Professional services for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes", "description": "Professional services for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0069", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Professional services for the administration of intravenous chemotherapy or other intravenous highly complex drug or biological infusion for each infusion drug administration calendar day in the individual's home, each 15 minutes", "description": "Professional services for the administration of intravenous chemotherapy or other intravenous highly complex drug or biological infusion for each infusion drug administration calendar day in the individual's home, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only", "description": "Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0071", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0076", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0077", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0078", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0079", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0081", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0082", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0084", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0085", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0086", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "description": "Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0087", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes", "description": "Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0088", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes", "description": "Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0089", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes", "description": "Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical or vaginal cancer screening; pelvic and clinical breast examination", "description": "Cervical or vaginal cancer screening; pelvic and clinical breast examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prostate cancer screening; digital rectal examination", "description": "Prostate cancer screening; digital rectal examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prostate cancer screening; prostate specific antigen test (psa)", "description": "Prostate cancer screening; prostate specific antigen test (psa)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0103", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; flexible sigmoidoscopy", "description": "Colorectal cancer screening; flexible sigmoidoscopy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0104", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; colonoscopy on individual at high risk", "description": "Colorectal cancer screening; colonoscopy on individual at high risk", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema", "description": "Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0106", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetes outpatient self-management training services, individual, per 30 minutes", "description": "Diabetes outpatient self-management training services, individual, per 30 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0108", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes", "description": "Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0109", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist", "description": "Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist", "description": "Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0118", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.", "description": "Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk", "description": "Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; barium enema", "description": "Colorectal cancer screening; barium enema", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision", "description": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0123", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician", "description": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0124", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trimming of dystrophic nails, any number", "description": "Trimming of dystrophic nails, any number", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0127", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes", "description": "Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0128", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per session (45 minutes or more)", "description": "Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per session (45 minutes or more)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0129", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)", "description": "Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician", "description": "Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0141", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision", "description": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0143", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision", "description": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0144", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision", "description": "Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision", "description": "Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0147", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening", "description": "Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0148", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes", "description": "Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0151", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes", "description": "Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0152", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes", "description": "Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes", "description": "Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0154", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services of clinical social worker in home health or hospice settings, each 15 minutes", "description": "Services of clinical social worker in home health or hospice settings, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0155", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services of home health/hospice aide in home health or hospice settings, each 15 minutes", "description": "Services of home health/hospice aide in home health or hospice settings, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0156", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes", "description": "Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0157", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes", "description": "Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0158", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes", "description": "Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0159", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes", "description": "Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes", "description": "Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skilled services by a registered nurse (rn) for management and evaluation of the plan of care; each 15 minutes (the patient's underlying condition or complication requires an rn to ensure that essential non-skilled care achieves its purpose in the home health or hospice setting)", "description": "Skilled services by a registered nurse (rn) for management and evaluation of the plan of care; each 15 minutes (the patient's underlying condition or complication requires an rn to ensure that essential non-skilled care achieves its purpose in the home health or hospice setting)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)", "description": "Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0163", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skilled services of a licensed nurse (lpn or rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes", "description": "Skilled services of a licensed nurse (lpn or rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0164", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External counterpulsation, per treatment session", "description": "External counterpulsation, per treatment session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0166", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wound closure utilizing tissue adhesive(s) only", "description": "Wound closure utilizing tissue adhesive(s) only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0168", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session", "description": "Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0173", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present", "description": "Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)", "description": "Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0176", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more)", "description": "Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0177", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care", "description": "Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0179", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care", "description": "Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans", "description": "Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more", "description": "Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0182", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)", "description": "Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed", "description": "Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral", "description": "Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral", "description": "Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pet imaging whole body; melanoma for non-covered indications", "description": "Pet imaging whole body; melanoma for non-covered indications", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0219", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pet imaging, any site, not otherwise specified", "description": "Pet imaging, any site, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0235", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)", "description": "Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0237", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)", "description": "Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0238", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)", "description": "Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0239", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education", "description": "Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education", "description": "Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails", "description": "Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results", "description": "Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests", "description": "Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0249", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests", "description": "Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment", "description": "Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0251", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)", "description": "Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0252", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve", "description": "Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility", "description": "Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection procedure for sacroiliac joint; arthrography", "description": "Injection procedure for sacroiliac joint; arthrography", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0259", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography", "description": "Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing", "description": "Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0268", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)", "description": "Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0269", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes", "description": "Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes", "description": "Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0271", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial", "description": "Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0276", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval", "description": "Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0277", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)", "description": "Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0278", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)", "description": "Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0279", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care", "description": "Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0281", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281", "description": "Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0282", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care", "description": "Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0283", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery", "description": "Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0288", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee", "description": "Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0289", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day", "description": "Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0293", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day", "description": "Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0294", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses", "description": "Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0295", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)", "description": "Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0296", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low dose ct scan (ldct) for lung cancer screening", "description": "Low dose ct scan (ldct) for lung cancer screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0297", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes", "description": "Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0299", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes", "description": "Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services", "description": "Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0302", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services", "description": "Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0303", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services", "description": "Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0304", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services", "description": "Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0305", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count", "description": "Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0306", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)", "description": "Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0307", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; blood-based biomarker", "description": "Colorectal cancer screening; blood-based biomarker", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0327", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous", "description": "Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0328", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care", "description": "Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0329", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary", "description": "Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0333", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice evaluation and counseling services, pre-election", "description": "Hospice evaluation and counseling services, pre-election", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0337", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment", "description": "Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0339", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment", "description": "Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous islet cell transplant, includes portal vein catheterization and infusion", "description": "Percutaneous islet cell transplant, includes portal vein catheterization and infusion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0341", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion", "description": "Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0342", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laparotomy for islet cell transplant, includes portal vein catheterization and infusion", "description": "Laparotomy for islet cell transplant, includes portal vein catheterization and infusion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0343", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service", "description": "Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)", "description": "Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0365", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician service required to establish and document the need for a power mobility device", "description": "Physician service required to establish and document the need for a power mobility device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0372", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital observation service, per hour", "description": "Hospital observation service, per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0378", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Direct admission of patient for hospital observation care", "description": "Direct admission of patient for hospital observation care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0379", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "description": "Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "description": "Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0381", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "description": "Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0382", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "description": "Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0383", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "description": "Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0384", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening", "description": "Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0389", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trauma response team associated with hospital critical care service", "description": "Trauma response team associated with hospital critical care service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes", "description": "Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0396", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes", "description": "Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0397", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation", "description": "Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0398", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation", "description": "Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0399", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels", "description": "Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment", "description": "Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0402", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report", "description": "Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0403", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination", "description": "Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0404", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination", "description": "Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0405", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth", "description": "Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0406", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth", "description": "Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0407", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth", "description": "Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0408", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)", "description": "Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0409", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes", "description": "Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes", "description": "Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0411", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed", "description": "Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0412", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)", "description": "Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0413", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)", "description": "Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0414", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)", "description": "Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0415", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method", "description": "Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0416", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens", "description": "Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0417", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens", "description": "Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0418", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens", "description": "Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0419", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour", "description": "Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour", "description": "Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0421", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session", "description": "Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0422", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session", "description": "Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0423", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day", "description": "Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0424", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth", "description": "Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0425", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth", "description": "Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0426", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth", "description": "Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0427", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)", "description": "Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0428", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)", "description": "Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0429", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter", "description": "Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0431", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening", "description": "Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0432", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening", "description": "Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0433", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter", "description": "Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0434", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening", "description": "Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0435", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes", "description": "Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0436", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes", "description": "Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0437", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit", "description": "Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0438", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit", "description": "Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0439", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Annual alcohol misuse screening, 15 minutes", "description": "Annual alcohol misuse screening, 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0442", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes", "description": "Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0443", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Annual depression screening, 15 minutes", "description": "Annual depression screening, 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0444", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes", "description": "High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0445", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes", "description": "Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0446", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Face-to-face behavioral counseling for obesity, 15 minutes", "description": "Face-to-face behavioral counseling for obesity, 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0447", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing", "description": "Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0448", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Development testing, with interpretation and report, per standardized instrument form", "description": "Development testing, with interpretation and report, per standardized instrument form", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0451", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Molecular pathology procedure; physician interpretation and report", "description": "Molecular pathology procedure; physician interpretation and report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)", "description": "Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0453", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist", "description": "Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0454", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen", "description": "Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters", "description": "Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0456", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters", "description": "Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0457", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low dose rate (ldr) prostate brachytherapy services, composite rate", "description": "Low dose rate (ldr) prostate brachytherapy services, composite rate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0458", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy", "description": "Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0459", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Autologous platelet rich plasma for chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment", "description": "Autologous platelet rich plasma for chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain", "description": "Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0461", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)", "description": "Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0462", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospital outpatient clinic visit for assessment and management of a patient", "description": "Hospital outpatient clinic visit for assessment and management of a patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0463", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)", "description": "Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0464", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit", "description": "Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0466", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit", "description": "Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0467", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv", "description": "Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0468", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit", "description": "Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0469", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit", "description": "Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)", "description": "Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0471", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis c antibody screening, for individual at high risk and other covered indication(s)", "description": "Hepatitis c antibody screening, for individual at high risk and other covered indication(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0472", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes", "description": "Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0473", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hiv antigen/antibody, combination assay, screening", "description": "Hiv antigen/antibody, combination assay, screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0475", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test", "description": "Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0476", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service", "description": "Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0477", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service", "description": "Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0478", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service", "description": "Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0479", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed", "description": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed", "description": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0481", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed", "description": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0482", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed", "description": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0483", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies; (services limited to rn or lpn only)", "description": "Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies; (services limited to rn or lpn only)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd", "description": "Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0491", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd", "description": "Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0492", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skilled services of a registered nurse (rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)", "description": "Skilled services of a registered nurse (rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0493", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skilled services of a licensed practical nurse (lpn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)", "description": "Skilled services of a licensed practical nurse (lpn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0494", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skilled services of a registered nurse (rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes", "description": "Skilled services of a registered nurse (rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0495", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skilled services of a licensed practical nurse (lpn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes", "description": "Skilled services of a licensed practical nurse (lpn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0496", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion", "description": "Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0498", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result", "description": "Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)", "description": "Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)", "description": "Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies", "description": "Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment", "description": "Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)", "description": "Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home", "description": "Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)", "description": "Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team", "description": "Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth", "description": "Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth", "description": "Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month", "description": "Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0511", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month", "description": "Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)", "description": "Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)", "description": "Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0514", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes", "description": "Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)", "description": "Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0516", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)", "description": "Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0517", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)", "description": "Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0518", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes", "description": "Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0659", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent hemoglobin (hgb) level > 12.0 g/dl", "description": "Most recent hemoglobin (hgb) level > 12.0 g/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0908", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemoglobin level measurement not documented, reason not given", "description": "Hemoglobin level measurement not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0909", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent hemoglobin level <= 12.0 g/dl", "description": "Most recent hemoglobin level <= 12.0 g/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Improvement in visual function achieved within 90 days following cataract surgery", "description": "Improvement in visual function achieved within 90 days following cataract surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0913", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient care survey was not completed by patient", "description": "Patient care survey was not completed by patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0914", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Improvement in visual function not achieved within 90 days following cataract surgery", "description": "Improvement in visual function not achieved within 90 days following cataract surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0915", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Satisfaction with care achieved within 90 days following cataract surgery", "description": "Satisfaction with care achieved within 90 days following cataract surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0916", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient satisfaction survey was not completed by patient", "description": "Patient satisfaction survey was not completed by patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0917", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Satisfaction with care not achieved within 90 days following cataract surgery", "description": "Satisfaction with care not achieved within 90 days following cataract surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0918", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit", "description": "Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0919", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Type, anatomic location, and activity all documented", "description": "Type, anatomic location, and activity all documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0920", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment)", "description": "Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0921", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation of disease type, anatomic location, and activity, reason not given", "description": "No documentation of disease type, anatomic location, and activity, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0922", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism applied pathways, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism applied pathways, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism evicore, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism evicore, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism medcurrent, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism medcurrent, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism national imaging associates, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism national imaging associates, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism test appropriate, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism test appropriate, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism cranberry peak, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism cranberry peak, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism sage health management solutions, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism sage health management solutions, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism, qualified tool not otherwise specified, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism, qualified tool not otherwise specified, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism agilemd, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism agilemd, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism evidencecare imaging advisor, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism evidencecare imaging advisor, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism inveniqa semantic answers in medicine, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism inveniqa semantic answers in medicine, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism reliant medical group, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism reliant medical group, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism speed of care, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism speed of care, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism healthhelp, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism healthhelp, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism infinx, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism infinx, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism logicnets, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism logicnets, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism curbside clinical augmented workflow, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism curbside clinical augmented workflow, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism ehealthline clinical decision support mechanism, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism ehealthline clinical decision support mechanism, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism intermountain clinical decision support mechanism, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism intermountain clinical decision support mechanism, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinical decision support mechanism persivia clinical decision support, as defined by the medicare appropriate use criteria program", "description": "Clinical decision support mechanism persivia clinical decision support, as defined by the medicare appropriate use criteria program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G1023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), performed in an approved ide-based clinical trial, per treatment session", "description": "Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), performed in an approved ide-based clinical trial, per treatment session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment", "description": "Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes", "description": "Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion", "description": "Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "description": "Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive (60 mins) home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility.)", "description": "Comprehensive (60 mins) home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill with chronic care management codes)", "description": "Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill with chronic care management codes)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Health care practitioners rendering treatment in place (tip)", "description": "Health care practitioners rendering treatment in place (tip)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "A model participant (ambulance supplier/provider), the beneficiary refuses services covered under the model (transport to an alternate destination/treatment in place)", "description": "A model participant (ambulance supplier/provider), the beneficiary refuses services covered under the model (transport to an alternate destination/treatment in place)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source", "description": "Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source", "description": "Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only", "description": "Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)).", "description": "Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)).", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2058", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes", "description": "Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2061", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes", "description": "Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2062", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes", "description": "Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2063", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive care management services for a single high-risk disease, e.g., principal care management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities", "description": "Comprehensive care management services for a single high-risk disease, e.g., principal care management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2064", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities", "description": "Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2065", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results", "description": "Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2066", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2067", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2068", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, buprenorphine (injectable); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, buprenorphine (injectable); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2069", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, buprenorphine (implant insertion); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, buprenorphine (implant insertion); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, buprenorphine (implant removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, buprenorphine (implant removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2071", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, buprenorphine (implant insertion and removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, buprenorphine (implant insertion and removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2072", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, naltrexone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, naltrexone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2073", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2074", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication assisted treatment, medication not otherwise specified; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program)", "description": "Medication assisted treatment, medication not otherwise specified; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2075", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a program physician qualified personnel that includes preparation of a treatment plan that includes the patient's short-term goals and the tasks the patient must perform to complete the short-term goals; the patient's requirements for education, vocational rehabilitation, and employment; and the medical, psycho- social, economic, legal, or other supportive services that a patient needs, conducted by qualified personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "description": "Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a program physician qualified personnel that includes preparation of a treatment plan that includes the patient's short-term goals and the tasks the patient must perform to complete the short-term goals; the patient's requirements for education, vocational rehabilitation, and employment; and the medical, psycho- social, economic, legal, or other supportive services that a patient needs, conducted by qualified personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2076", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "description": "Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2077", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "description": "Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2078", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "description": "Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2079", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Each additional 30 minutes of counseling in a week of medication assisted treatment, (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "description": "Each additional 30 minutes of counseling in a week of medication assisted treatment, (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients age 66 and older in institutional special needs plans (snp) or residing in long-term care with a pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period", "description": "Patients age 66 and older in institutional special needs plans (snp) or residing in long-term care with a pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2081", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation", "description": "Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2082", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation", "description": "Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month", "description": "Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2086", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month", "description": "Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2087", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)", "description": "Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2088", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0%", "description": "Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0%", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2089", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2091", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) or angiotensin receptor-neprilysin inhibitor (arni) therapy prescribed or currently being taken", "description": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) or angiotensin receptor-neprilysin inhibitor (arni) therapy prescribed or currently being taken", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2092", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., hypotensive patients who are at immediate risk of cardiogenic shock, hospitalized patients who have experienced marked azotemia, allergy, intolerance, other medical reasons)", "description": "Documentation of medical reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., hypotensive patients who are at immediate risk of cardiogenic shock, hospitalized patients who have experienced marked azotemia, allergy, intolerance, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2093", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., patient declined, other patient reasons)", "description": "Documentation of patient reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., patient declined, other patient reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2094", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of system reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., other system reasons)", "description": "Documentation of system reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., other system reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2095", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) or angiotensin receptor-neprilysin inhibitor (arni) therapy was not prescribed, reason not given", "description": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) or angiotensin receptor-neprilysin inhibitor (arni) therapy was not prescribed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2096", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Episodes where the patient had a competing diagnosis within three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, chronic sinusitis, infection of the adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti)", "description": "Episodes where the patient had a competing diagnosis within three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, chronic sinusitis, infection of the adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2097", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2098", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2099", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed", "description": "Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Seven standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed", "description": "Seven standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2103", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Eye imaging validated to match diagnosis from seven standard field stereoscopic photos results documented and reviewed", "description": "Eye imaging validated to match diagnosis from seven standard field stereoscopic photos results documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2104", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period", "description": "Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2106", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2107", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period", "description": "Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2108", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2109", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving <=5 mg daily prednisone (or equivalent), or ra activity is worsening, or glucocorticoid use is for less than 6 months", "description": "Patient receiving <=5 mg daily prednisone (or equivalent), or ra activity is worsening, or glucocorticoid use is for less than 6 months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving >5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity", "description": "Patient receiving >5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2114", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2115", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2116", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 81 years of age and older with at least one claim/encounter for frailty during the measurement period", "description": "Patients 81 years of age and older with at least one claim/encounter for frailty during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2118", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Within the past 2 years, calcium and/or vitamin d optimization has been ordered or performed", "description": "Within the past 2 years, calcium and/or vitamin d optimization has been ordered or performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2119", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Within the past 2 years, calcium and/or vitamin d optimization has not been ordered or performed", "description": "Within the past 2 years, calcium and/or vitamin d optimization has not been ordered or performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psychosis, depression, anxiety, apathy, and impulse control disorder assessed", "description": "Psychosis, depression, anxiety, apathy, and impulse control disorder assessed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psychosis, depression, anxiety, apathy, and impulse control disorder not assessed", "description": "Psychosis, depression, anxiety, apathy, and impulse control disorder not assessed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2123", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and a dispensed dementia medication", "description": "Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and a dispensed dementia medication", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2124", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 81 years of age and older with at least one claim/encounter for frailty during the six months prior to the measurement period through december 31 of the measurement period", "description": "Patients 81 years of age and older with at least one claim/encounter for frailty during the six months prior to the measurement period through december 31 of the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2125", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2127", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g. history of gastrointestinal bleed, intra-cranial bleed, blood disorders, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)", "description": "Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g. history of gastrointestinal bleed, intra-cranial bleed, blood disorders, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2128", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Procedure-related bp's not taken during an outpatient visit. examples include same day surgery, ambulatory service center, g.i. lab, dialysis, infusion center, chemotherapy", "description": "Procedure-related bp's not taken during an outpatient visit. examples include same day surgery, ambulatory service center, g.i. lab, dialysis, infusion center, chemotherapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2129", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period", "description": "Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 81 years and older with a diagnosis of frailty", "description": "Patients 81 years and older with a diagnosis of frailty", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2132", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2133", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age or older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age or older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2134", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients 66 years of age or older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "description": "Patients 66 years of age or older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2135", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back pain measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated an improvement of 5.0 points or greater", "description": "Back pain measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated an improvement of 5.0 points or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2136", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back pain measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated a change of less than an improvement of 5.0 points", "description": "Back pain measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated a change of less than an improvement of 5.0 points", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2137", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back pain as measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of 5.0 points or greater", "description": "Back pain as measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of 5.0 points or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2138", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back pain measured by the visual analog scale (vas) pain at one year (9 to 15 months) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of less than 5.0", "description": "Back pain measured by the visual analog scale (vas) pain at one year (9 to 15 months) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of less than 5.0", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2139", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg pain measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively was less than or equal to 3.0 or leg pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated an improvement of 5.0 points or greater", "description": "Leg pain measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively was less than or equal to 3.0 or leg pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated an improvement of 5.0 points or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg pain measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively was greater than 3.0 and leg pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated less than an improvement of 5.0 points", "description": "Leg pain measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively was greater than 3.0 and leg pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated less than an improvement of 5.0 points", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2141", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of 30 points or greater", "description": "Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of 30 points or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2142", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of less than 30 points", "description": "Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of less than 30 points", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2143", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated a change of 30 points or greater", "description": "Functional status measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated a change of 30 points or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2144", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated a change of less than 30 points", "description": "Functional status measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated a change of less than 30 points", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg pain as measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or leg pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 5.0 points or greater", "description": "Leg pain as measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or leg pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 5.0 points or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2146", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg pain measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was greater than 3.0 and leg pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated less than an improvement of 5.0 points", "description": "Leg pain measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was greater than 3.0 and leg pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated less than an improvement of 5.0 points", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2147", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Performance met: multimodal pain management was used", "description": "Performance met: multimodal pain management was used", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2148", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not using multimodal pain management (e.g., allergy to multiple classes of analgesics, intubated patient, hepatic failure, patient reports no pain during pacu stay, other medical reason(s))", "description": "Documentation of medical reason(s) for not using multimodal pain management (e.g., allergy to multiple classes of analgesics, intubated patient, hepatic failure, patient reports no pain during pacu stay, other medical reason(s))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2149", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Performance not met: multimodal pain management was not used", "description": "Performance not met: multimodal pain management was not used", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "description": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2151", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the neck impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "description": "Risk-adjusted functional status change residual score for the neck impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2152", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "In hospice or using hospice services during the measurement period", "description": "In hospice or using hospice services during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period", "description": "Patient received at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2154", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)", "description": "Patient had history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2155", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period; or have history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)", "description": "Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period; or have history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2156", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients received both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during the measurement period", "description": "Patients received both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2157", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had prior pneumococcal vaccine adverse reaction any time during or before the measurement period", "description": "Patient had prior pneumococcal vaccine adverse reaction any time during or before the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2158", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during measurement period; or have prior pneumococcal vaccine adverse reaction any time during or before the measurement period", "description": "Patient did not receive both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during measurement period; or have prior pneumococcal vaccine adverse reaction any time during or before the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2159", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period", "description": "Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period", "description": "Patient had prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period; or have prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period", "description": "Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient's 50th birthday before or during the measurement period; or have prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period", "description": "Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2163", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had a prior influenza virus vaccine adverse reaction any time before or during the measurement period", "description": "Patient had a prior influenza virus vaccine adverse reaction any time before or during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2164", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period; or did not have a prior influenza virus vaccine adverse reaction any time before or during the measurement period", "description": "Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period; or did not have a prior influenza virus vaccine adverse reaction any time before or during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2165", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate at admission and/or discharge; patient unable to complete the neck fs prom at admission or discharge due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, and a suitable proxy/recorder is not available; patient self-discharged early; medical reason", "description": "Patient refused to participate at admission and/or discharge; patient unable to complete the neck fs prom at admission or discharge due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, and a suitable proxy/recorder is not available; patient self-discharged early; medical reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2166", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the neck impairment successfully calculated and the score was less than zero (< 0)", "description": "Risk-adjusted functional status change residual score for the neck impairment successfully calculated and the score was less than zero (< 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2167", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes", "description": "Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2168", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes", "description": "Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2169", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous arteriovenous fistula creation (avf), direct, any site, by tissue approximation using thermal resistance energy, and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization) when performed, and includes all imaging and radiologic guidance, supervision and interpretation, when performed", "description": "Percutaneous arteriovenous fistula creation (avf), direct, any site, by tissue approximation using thermal resistance energy, and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization) when performed, and includes all imaging and radiologic guidance, supervision and interpretation, when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous arteriovenous fistula creation (avf), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, wen performed) and fistulogram(s), angiography, enography, and/or ultrasound, with radiologic supervision and interpretation, when performed", "description": "Percutaneous arteriovenous fistula creation (avf), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, wen performed) and fistulogram(s), angiography, enography, and/or ultrasound, with radiologic supervision and interpretation, when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project", "description": "All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2172", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)", "description": "Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2173", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date", "description": "Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2174", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)", "description": "Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Outpatient, ed, or observation visits that result in an inpatient admission", "description": "Outpatient, ed, or observation visits that result in an inpatient admission", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2176", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date", "description": "Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2177", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure, for example patient bilateral amputee; patient has condition that would not allow them to accurately respond to a neurological exam (dementia, alzheimer's, etc.); patient has previously documented diabetic peripheral neuropathy with loss of protective sensation", "description": "Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure, for example patient bilateral amputee; patient has condition that would not allow them to accurately respond to a neurological exam (dementia, alzheimer's, etc.); patient has previously documented diabetic peripheral neuropathy with loss of protective sensation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2178", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient had medical reason for not performing lower extremity neurological exam", "description": "Clinician documented that patient had medical reason for not performing lower extremity neurological exam", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2179", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee", "description": "Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi not documented due to medical reason or patient refusal of height or weight measurement", "description": "Bmi not documented due to medical reason or patient refusal of height or weight measurement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy", "description": "Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2182", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation patient unable to communicate and informant not available", "description": "Documentation patient unable to communicate and informant not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2183", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient does not have a caregiver", "description": "Patient does not have a caregiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2184", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation caregiver is trained and certified in dementia care", "description": "Documentation caregiver is trained and certified in dementia care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed", "description": "Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: head trauma", "description": "Patients with clinical indications for imaging of the head: head trauma", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2187", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age", "description": "Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2188", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: abnormal neurologic exam", "description": "Patients with clinical indications for imaging of the head: abnormal neurologic exam", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2189", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: headache radiating to the neck", "description": "Patients with clinical indications for imaging of the head: headache radiating to the neck", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: positional headaches", "description": "Patients with clinical indications for imaging of the head: positional headaches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2191", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age", "description": "Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2192", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)", "description": "Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2193", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior", "description": "Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2194", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head: occipital headache in children", "description": "Patients with clinical indications for imaging of the head: occipital headache in children", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2195", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method", "description": "Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2196", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user", "description": "Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2197", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g., limited life expectancy, other medical reasons)", "description": "Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g., limited life expectancy, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2198", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not screened for unhealthy alcohol use using a systematic screening method, reason not given", "description": "Patient not screened for unhealthy alcohol use using a systematic screening method, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient identified as an unhealthy alcohol user received brief counseling", "description": "Patient identified as an unhealthy alcohol user received brief counseling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)", "description": "Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive brief counseling if identified as an unhealthy alcohol user, reason not given", "description": "Patient did not receive brief counseling if identified as an unhealthy alcohol user, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons)", "description": "Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period", "description": "Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with pregnancy during adjuvant treatment course", "description": "Patients with pregnancy during adjuvant treatment course", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy", "description": "Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50), cardiac contraindications, insufficient renal function, insufficient hepatic function, other active or secondary cancer diagnoses, other medical contraindications, patients who died during initial treatment course or transferred during or after initial treatment course)", "description": "Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50), cardiac contraindications, insufficient renal function, insufficient hepatic function, other active or secondary cancer diagnoses, other medical contraindications, patients who died during initial treatment course or transferred during or after initial treatment course)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy", "description": "Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate", "description": "Patient refused to participate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or near discharge, reason not given", "description": "Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or near discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)", "description": "Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99354, 99355, 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)", "description": "Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99354, 99355, 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)", "description": "Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional", "description": "Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "description": "Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "description": "Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment", "description": "Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion", "description": "Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2251", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion", "description": "Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2252", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration and supply of tositumomab, 450 mg", "description": "Administration and supply of tositumomab, 450 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G3001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultrasonic guidance for placement of radiation therapy fields", "description": "Ultrasonic guidance for placement of radiation therapy fields", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy", "description": "Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev", "description": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev", "description": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev", "description": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater", "description": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev", "description": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev", "description": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev", "description": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater", "description": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev", "description": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev", "description": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev", "description": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 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"HCPCS", "billing_code_type_version": "2022", "billing_code": "G6016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg,3d positional tracking, gating, 3d surface tracking), each fraction of treatment", "description": "Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg,3d positional tracking, gating, 3d surface tracking), each fraction of treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation)", "description": "Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique", "description": "Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)", "description": "Colonoscopy through stoma; with transendoscopic stent placement (includes 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"outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesions(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique", "description": "Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesions(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation)", "description": "Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colonoscopy, flexible; proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique", "description": "Colonoscopy, flexible; proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)", "description": "Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); diagnostic, including collection of specimen(s) by brushing or washing when performed", "description": "Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); diagnostic, including collection of specimen(s) by brushing or washing when performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)", "description": "Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amitriptyline", "description": "Amitriptyline", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Benzodiazepines", "description": "Benzodiazepines", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Desipramine", "description": "Desipramine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Doxepin", "description": "Doxepin", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gold", "description": "Gold", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assay of imipramine", "description": "Assay of imipramine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nortriptyline", "description": "Nortriptyline", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Salicylate", "description": "Salicylate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Acetaminophen", "description": "Acetaminophen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol (ethanol); any specimen except breath", "description": "Alcohol (ethanol); any specimen except breath", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alkaloids, urine, quantitative", "description": "Alkaloids, urine, quantitative", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amphetamine or methamphetamine", "description": "Amphetamine or methamphetamine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Barbiturates, not elsewhere specified", "description": "Barbiturates, not elsewhere specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cocaine or metabolite", "description": "Cocaine or metabolite", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dihydrocodeinone", "description": "Dihydrocodeinone", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dihydromorphinone", "description": "Dihydromorphinone", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dihydrotestosterone", "description": "Dihydrotestosterone", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dimethadione", "description": "Dimethadione", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6048", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Epiandrosterone", "description": "Epiandrosterone", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6049", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ethchlorvynol", "description": "Ethchlorvynol", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Flurazepam", "description": "Flurazepam", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6051", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Meprobamate", "description": "Meprobamate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methadone", "description": "Methadone", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6053", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methsuximide", "description": "Methsuximide", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6054", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nicotine", "description": "Nicotine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Opiate(s), drug and metabolites, each procedure", "description": "Opiate(s), drug and metabolites, each procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6056", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Phenothiazine", "description": "Phenothiazine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6057", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug confirmation, each procedure", "description": "Drug confirmation, each procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6058", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase", "description": "Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase", "description": "Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8127", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure", "description": "Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8128", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function", "description": "Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8395", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Left ventricular ejection fraction (lvef) not performed or documented", "description": "Left ventricular ejection fraction (lvef) not performed or documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8396", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy", "description": "Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8397", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dilated macular or fundus exam not performed", "description": "Dilated macular or fundus exam not performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8398", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed", "description": "Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8399", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given", "description": "Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for screening", "description": "Clinician documented that patient was not an eligible candidate for screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8401", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lower extremity neurological exam performed and documented", "description": "Lower extremity neurological exam performed and documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8404", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lower extremity neurological exam not performed", "description": "Lower extremity neurological exam not performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8405", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure", "description": "Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8406", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Footwear evaluation performed and documented", "description": "Footwear evaluation performed and documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Footwear evaluation was not performed", "description": "Footwear evaluation was not performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8415", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for footwear evaluation measure", "description": "Clinician documented that patient was not an eligible candidate for footwear evaluation measure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8416", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi is documented above normal parameters and a follow-up plan is documented", "description": "Bmi is documented above normal parameters and a follow-up plan is documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8417", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi is documented below normal parameters and a follow-up plan is documented", "description": "Bmi is documented below normal parameters and a follow-up plan is documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8418", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi documented outside normal parameters, no follow-up plan documented, no reason given", "description": "Bmi documented outside normal parameters, no follow-up plan documented, no reason given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8419", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi is documented within normal parameters and no follow-up plan is required", "description": "Bmi is documented within normal parameters and no follow-up plan is required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi not documented and no reason is given", "description": "Bmi not documented and no reason is given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8421", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi not documented, documentation the patient is not eligible for bmi calculation", "description": "Bmi not documented, documentation the patient is not eligible for bmi calculation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8422", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications", "description": "Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8427", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given", "description": "Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8428", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an urgent or emergent medical situation)", "description": "Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an urgent or emergent medical situation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening for depression is documented as being positive and a follow-up plan is documented", "description": "Screening for depression is documented as being positive and a follow-up plan is documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8431", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Depression screening not documented, reason not given", "description": "Depression screening not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8432", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening for depression not completed, documented reason", "description": "Screening for depression not completed, documented reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8433", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter", "description": "Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8442", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Beta-blocker therapy prescribed", "description": "Beta-blocker therapy prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Beta-blocker therapy for lvef < 40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons, or other reasons attributable to the healthcare system)", "description": "Beta-blocker therapy for lvef < 40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons, or other reasons attributable to the healthcare system)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8451", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Beta-blocker therapy not prescribed", "description": "Beta-blocker therapy not prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)", "description": "Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8458", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c", "description": "Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving antiviral treatment for hepatitis c during the measurement period", "description": "Patient receiving antiviral treatment for hepatitis c during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8461", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined", "description": "Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8464", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High or very high risk of recurrence of prostate cancer", "description": "High or very high risk of recurrence of prostate cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed", "description": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8473", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons) or (e.g., lack of drug availability, other reasons attributable to the health care system)", "description": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons) or (e.g., lack of drug availability, other reasons attributable to the health care system)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8474", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given", "description": "Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8475", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg", "description": "Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8476", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg", "description": "Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8477", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood pressure measurement not performed or documented, reason not given", "description": "Blood pressure measurement not performed or documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8478", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza immunization administered or previously received", "description": "Influenza immunization administered or previously received", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8482", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)", "description": "Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8483", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza immunization was not administered, reason not given", "description": "Influenza immunization was not administered, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8484", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the diabetes mellitus (dm) measures group", "description": "I intend to report the diabetes mellitus (dm) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the preventive care measures group", "description": "I intend to report the preventive care measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8486", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the chronic kidney disease (ckd) measures group", "description": "I intend to report the chronic kidney disease (ckd) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8487", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the coronary artery disease (cad) measures group", "description": "I intend to report the coronary artery disease (cad) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8489", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the rheumatoid arthritis (ra) measures group", "description": "I intend to report the rheumatoid arthritis (ra) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the hiv/aids measures group", "description": "I intend to report the hiv/aids measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8491", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the perioperative care measures group", "description": "I intend to report the perioperative care measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8492", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the back pain measures group", "description": "I intend to report the back pain measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8493", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8494", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8495", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the preventive care measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the preventive care measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8496", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8497", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8498", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the back pain measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the back pain measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy", "description": "Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given", "description": "Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening for depression is documented as negative, a follow-up plan is not required", "description": "Screening for depression is documented as negative, a follow-up plan is not required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening for depression documented as positive, follow-up plan not documented, reason not given", "description": "Screening for depression documented as positive, follow-up plan not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8511", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Autogenous av fistula received", "description": "Autogenous av fistula received", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for autogenous av fistula", "description": "Clinician documented that patient was not an eligible candidate for autogenous av fistula", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8531", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient received vascular access other than autogenous av fistula, reason not given", "description": "Clinician documented that patient received vascular access other than autogenous av fistula, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8532", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter", "description": "Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8535", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation of an elder maltreatment screen, reason not given", "description": "No documentation of an elder maltreatment screen, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8536", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies on the date of functional outcome assessment, is documented", "description": "Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies on the date of functional outcome assessment, is documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8539", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter", "description": "Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional outcome assessment using a standardized tool not documented, reason not given", "description": "Functional outcome assessment using a standardized tool not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8541", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required", "description": "Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8542", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented, reason not given", "description": "Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8543", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the coronary artery bypass graft (cabg) measures group", "description": "I intend to report the coronary artery bypass graft (cabg) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8544", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the hepatitis c measures group", "description": "I intend to report the hepatitis c measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8545", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the ischemic vascular disease (ivd) measures group", "description": "I intend to report the ischemic vascular disease (ivd) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8547", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the heart failure (hf) measures group", "description": "I intend to report the heart failure (hf) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8548", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8549", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8551", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8552", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation", "description": "Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8559", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has a history of active drainage from the ear within the previous 90 days", "description": "Patient has a history of active drainage from the ear within the previous 90 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure", "description": "Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8561", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient does not have a history of active drainage from the ear within the previous 90 days", "description": "Patient does not have a history of active drainage from the ear within the previous 90 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given", "description": "Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8563", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)", "description": "Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8564", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Verification and documentation of sudden or rapidly progressive hearing loss", "description": "Verification and documentation of sudden or rapidly progressive hearing loss", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8565", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is not eligible for the \"referral for otologic evaluation for sudden or rapidly progressive hearing loss\" measure", "description": "Patient is not eligible for the \"referral for otologic evaluation for sudden or rapidly progressive hearing loss\" measure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8566", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient does not have verification and documentation of sudden or rapidly progressive hearing loss", "description": "Patient does not have verification and documentation of sudden or rapidly progressive hearing loss", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8567", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given", "description": "Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8568", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prolonged postoperative intubation (> 24 hrs) required", "description": "Prolonged postoperative intubation (> 24 hrs) required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8569", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prolonged postoperative intubation (> 24 hrs) not required", "description": "Prolonged postoperative intubation (> 24 hrs) not required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Development of deep sternal wound infection/mediastinitis within 30 days postoperatively", "description": "Development of deep sternal wound infection/mediastinitis within 30 days postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8571", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No deep sternal wound infection/mediastinitis", "description": "No deep sternal wound infection/mediastinitis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8572", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stroke following isolated cabg surgery", "description": "Stroke following isolated cabg surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8573", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No stroke following isolated cabg surgery", "description": "No stroke following isolated cabg surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8574", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Developed postoperative renal failure or required dialysis", "description": "Developed postoperative renal failure or required dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8575", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No postoperative renal failure/dialysis not required", "description": "No postoperative renal failure/dialysis not required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8576", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason", "description": "Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8577", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason", "description": "Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8578", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antiplatelet medication at discharge", "description": "Antiplatelet medication at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8579", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antiplatelet medication contraindicated", "description": "Antiplatelet medication contraindicated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No antiplatelet medication at discharge", "description": "No antiplatelet medication at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8581", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Beta-blocker at discharge", "description": "Beta-blocker at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8582", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Beta-blocker contraindicated", "description": "Beta-blocker contraindicated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8583", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No beta-blocker at discharge", "description": "No beta-blocker at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8584", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anti-lipid treatment at discharge", "description": "Anti-lipid treatment at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8585", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anti-lipid treatment contraindicated", "description": "Anti-lipid treatment contraindicated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8586", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No anti-lipid treatment at discharge", "description": "No anti-lipid treatment at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8587", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)", "description": "Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8593", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lipid profile not performed, reason not given", "description": "Lipid profile not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8594", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent ldl-c < 100 mg/dl", "description": "Most recent ldl-c < 100 mg/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8595", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent ldl-c >= 100 mg/dl", "description": "Most recent ldl-c >= 100 mg/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8597", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aspirin or another antiplatelet therapy used", "description": "Aspirin or another antiplatelet therapy used", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8598", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aspirin or another antiplatelet therapy not used, reason not given", "description": "Aspirin or another antiplatelet therapy not used, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8599", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iv t-pa initiated within three hours (<= 180 minutes) of time last known well", "description": "Iv t-pa initiated within three hours (<= 180 minutes) of time last known well", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iv alteplase not initiated within three hours (<= 180 minutes) of time last known well for reasons documented by clinician (e.g. patient enrolled in clinical trial for stroke, patient admitted for elective carotid intervention, patient received tenecteplase (tnk))", "description": "Iv alteplase not initiated within three hours (<= 180 minutes) of time last known well for reasons documented by clinician (e.g. patient enrolled in clinical trial for stroke, patient admitted for elective carotid intervention, patient received tenecteplase (tnk))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8601", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well, reason not given", "description": "Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8602", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical procedure performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)", "description": "Surgical procedure performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical procedure not performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)", "description": "Surgical procedure not performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of order for prophylactic parenteral antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)", "description": "Documentation of order for prophylactic parenteral antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that administration of prophylactic parenteral antibiotics was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered", "description": "Documentation that administration of prophylactic parenteral antibiotics was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for ordering prophylactic parenteral antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)", "description": "Clinician documented that patient was not an eligible candidate for ordering prophylactic parenteral antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prophylactic parenteral antibiotics were not ordered to be given or given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not given", "description": "Prophylactic parenteral antibiotics were not ordered to be given or given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacologic therapy (other than minierals/vitamins) for osteoporosis prescribed", "description": "Pharmacologic therapy (other than minierals/vitamins) for osteoporosis prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8633", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis", "description": "Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8634", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacologic therapy for osteoporosis was not prescribed, reason not given", "description": "Pharmacologic therapy for osteoporosis was not prescribed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the asthma measures group", "description": "I intend to report the asthma measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8645", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the asthma measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the asthma measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8646", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the knee impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "description": "Risk-adjusted functional status change residual score for the knee impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8647", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the knee impairment successfully calculated and the score was less than zero (< 0)", "description": "Risk-adjusted functional status change residual score for the knee impairment successfully calculated and the score was less than zero (< 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8648", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the knee impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "description": "Risk-adjusted functional status change residual score for the knee impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8649", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the knee impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given", "description": "Risk-adjusted functional status change residual score for the knee impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the hip impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "description": "Risk-adjusted functional status change residual score for the hip impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8651", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the hip impairment successfully calculated and the score was less than zero (< 0)", "description": "Risk-adjusted functional status change residual score for the hip impairment successfully calculated and the score was less than zero (< 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8652", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual scores for the hip impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "description": "Risk-adjusted functional status change residual scores for the hip impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8653", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the hip impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given", "description": "Risk-adjusted functional status change residual score for the hip impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8654", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment successfully calculated and the score was equal to zero (0) or greater than zero ( > 0)", "description": "Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment successfully calculated and the score was equal to zero (0) or greater than zero ( > 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8655", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment successfully calculated and the score was less than zero (< 0)", "description": "Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment successfully calculated and the score was less than zero (< 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8656", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "description": "Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8657", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given", "description": "Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8658", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the low back impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "description": "Risk-adjusted functional status change residual score for the low back impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8659", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the low back impairment successfully calculated and the score was less than zero (< 0)", "description": "Risk-adjusted functional status change residual score for the low back impairment successfully calculated and the score was less than zero (< 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "description": "Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8661", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the low back fs prom at initial evaluation and/or near discharge, reason not given", "description": "Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the low back fs prom at initial evaluation and/or near discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8662", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the shoulder impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "description": "Risk-adjusted functional status change residual score for the shoulder impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8663", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the shoulder impairment successfully calculated and the score was less than zero (< 0)", "description": "Risk-adjusted functional status change residual score for the shoulder impairment successfully calculated and the score was less than zero (< 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8664", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "description": "Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8665", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the shoulder fs prom at initial evaluation and/or near discharge, reason not given", "description": "Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the shoulder fs prom at initial evaluation and/or near discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8666", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "description": "Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8667", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment successfully calculated and the score was less than zero (< 0)", "description": "Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment successfully calculated and the score was less than zero (< 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8668", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "description": "Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8669", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the elbow/wrist/hand fs prom at initial evaluation and/or near discharge, reason not given", "description": "Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the elbow/wrist/hand fs prom at initial evaluation and/or near discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "description": "Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8671", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was less than zero (< 0)", "description": "Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was less than zero (< 0)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8672", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "description": "Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8673", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the general orthopedic fs prom at initial evaluation and/or near discharge, reason not given", "description": "Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the general orthopedic fs prom at initial evaluation and/or near discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8674", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lvf testing documented as being performed prior to discharge or in the previous 12 months", "description": "Lvf testing documented as being performed prior to discharge or in the previous 12 months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8682", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reason", "description": "Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8683", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given", "description": "Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8685", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Left ventricular ejection fraction (lvef) < 40% or documentation of moderate or severe lvsd", "description": "Left ventricular ejection fraction (lvef) < 40% or documentation of moderate or severe lvsd", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8694", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antithrombotic therapy prescribed at discharge", "description": "Antithrombotic therapy prescribed at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8696", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))", "description": "Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8697", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antithrombotic therapy was not prescribed at discharge, reason not given", "description": "Antithrombotic therapy was not prescribed at discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8698", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge", "description": "Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge", "description": "Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rehabilitation services were not ordered, reason not otherwise specified", "description": "Rehabilitation services were not ordered, reason not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8701", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively", "description": "Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8702", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively", "description": "Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8703", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "12-lead electrocardiogram (ecg) performed", "description": "12-lead electrocardiogram (ecg) performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8704", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)", "description": "Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8705", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)", "description": "Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8706", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "12-lead electrocardiogram (ecg) not performed, reason not given", "description": "12-lead electrocardiogram (ecg) not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8707", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not prescribed or dispensed antibiotic", "description": "Patient not prescribed or dispensed antibiotic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8708", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne)", "description": "Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8709", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient prescribed or dispensed antibiotic", "description": "Patient prescribed or dispensed antibiotic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prescribed or dispensed antibiotic", "description": "Prescribed or dispensed antibiotic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8711", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antibiotic not prescribed or dispensed", "description": "Antibiotic not prescribed or dispensed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8712", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])", "description": "Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8713", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemodialysis treatment performed exactly three times per week for > 90 days", "description": "Hemodialysis treatment performed exactly three times per week for > 90 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8714", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not given", "description": "Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8717", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])", "description": "Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8718", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])", "description": "Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report", "description": "Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8721", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal)", "description": "Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8722", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site is other than anatomic location of primary tumor", "description": "Specimen site is other than anatomic location of primary tumor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8723", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pt category, pn category and histologic grade were not documented in the pathology report, reason not given", "description": "Pt category, pn category and histologic grade were not documented in the pathology report, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8724", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)", "description": "Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8725", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)", "description": "Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8726", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fasting lipid profile not performed, reason not given", "description": "Fasting lipid profile not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8728", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pain assessment documented as positive using a standardized tool and a follow-up plan is documented", "description": "Pain assessment documented as positive using a standardized tool and a follow-up plan is documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pain assessment using a standardized tool is documented as negative, no follow-up plan required", "description": "Pain assessment using a standardized tool is documented as negative, no follow-up plan required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8731", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation of pain assessment, reason not given", "description": "No documentation of pain assessment, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8732", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elder maltreatment screen documented as positive and a follow-up plan is documented", "description": "Elder maltreatment screen documented as positive and a follow-up plan is documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8733", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elder maltreatment screen documented as negative, no follow-up required", "description": "Elder maltreatment screen documented as negative, no follow-up required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8734", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given", "description": "Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8735", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most current ldl-c <100mg/dl", "description": "Most current ldl-c <100mg/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8736", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most current ldl-c >=100mg/dl", "description": "Most current ldl-c >=100mg/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8737", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Left ventricular ejection fraction (lvef) < 40% or documentation of severely or moderately depressed left ventricular systolic function", "description": "Left ventricular ejection fraction (lvef) < 40% or documentation of severely or moderately depressed left ventricular systolic function", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8738", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function", "description": "Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8739", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Left ventricular ejection fraction (lvef) not performed or assessed, reason not given", "description": "Left ventricular ejection fraction (lvef) not performed or assessed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Absence of signs of melanoma (tenderness, jaundice, localized neurologic signs such as weakness, or any other sign suggesting systemic spread) or absence of symptoms of melanoma (cough, dyspnea, pain, paresthesia, or any other symptom suggesting the possibility of systemic spread of melanoma)", "description": "Absence of signs of melanoma (tenderness, jaundice, localized neurologic signs such as weakness, or any other sign suggesting systemic spread) or absence of symptoms of melanoma (cough, dyspnea, pain, paresthesia, or any other symptom suggesting the possibility of systemic spread of melanoma)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8749", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Smoking status and exposure to second hand smoke in the home not assessed, reason not given", "description": "Smoking status and exposure to second hand smoke in the home not assessed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8751", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent systolic blood pressure < 140 mmhg", "description": "Most recent systolic blood pressure < 140 mmhg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8752", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent systolic blood pressure >= 140 mmhg", "description": "Most recent systolic blood pressure >= 140 mmhg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8753", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent diastolic blood pressure < 90 mmhg", "description": "Most recent diastolic blood pressure < 90 mmhg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8754", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent diastolic blood pressure >= 90 mmhg", "description": "Most recent diastolic blood pressure >= 90 mmhg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8755", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation of blood pressure measurement, reason not given", "description": "No documentation of blood pressure measurement, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8756", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8757", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8758", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8759", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the dementia measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the dementia measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8761", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the parkinson's disease measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the parkinson's disease measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8762", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the hypertension (htn) measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the hypertension (htn) measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8763", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the cardiovascular prevention measures group have bee performed for this patient", "description": "All quality actions for the applicable measures in the cardiovascular prevention measures group have bee performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8764", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the cataract measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the cataract measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8765", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lipid panel results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)", "description": "Lipid panel results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8767", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not performing lipid profile (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "description": "Documentation of medical reason(s) for not performing lipid profile (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8768", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lipid profile not performed, reason not given", "description": "Lipid profile not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8769", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urine protein test result documented and reviewed", "description": "Urine protein test result documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of diagnosis of chronic kidney disease", "description": "Documentation of diagnosis of chronic kidney disease", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8771", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not performing urine protein test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not cllinically appropriate)", "description": "Documentation of medical reason(s) for not performing urine protein test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not cllinically appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8772", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Urine protein test was not performed, reason not given", "description": "Urine protein test was not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8773", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Serum creatinine test result documented and reviewed", "description": "Serum creatinine test result documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8774", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not performing serum creatinine test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "description": "Documentation of medical reason(s) for not performing serum creatinine test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8775", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Serum creatinine test not performed, reason not given", "description": "Serum creatinine test not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8776", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetes screening test performed", "description": "Diabetes screening test performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8777", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not performing diabetes screening test (e.g., patients with a diagnosis of diabetes, or with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "description": "Documentation of medical reason(s) for not performing diabetes screening test (e.g., patients with a diagnosis of diabetes, or with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8778", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetes screening test not performed, reason not given", "description": "Diabetes screening test not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8779", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Counseling for diet and physical activity performed", "description": "Counseling for diet and physical activity performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for patient not receiving counseling for diet and physical activity (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "description": "Documentation of medical reason(s) for patient not receiving counseling for diet and physical activity (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8781", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Counseling for diet and physical activity not performed, reason not given", "description": "Counseling for diet and physical activity not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8782", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Normal blood pressure reading documented, follow-up not required", "description": "Normal blood pressure reading documented, follow-up not required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8783", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)", "description": "Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8784", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood pressure reading not documented, reason not given", "description": "Blood pressure reading not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8785", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site other than anatomic location of esophagus", "description": "Specimen site other than anatomic location of esophagus", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8797", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site other than anatomic location of prostate", "description": "Specimen site other than anatomic location of prostate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8798", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented", "description": "Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8806", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has visited the ed multiple times within 72 hours, patient has a documented intrauterine pregnancy [iup])", "description": "Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has visited the ed multiple times within 72 hours, patient has a documented intrauterine pregnancy [iup])", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8807", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trans-abdominal or trans-vaginal ultrasound not performed, reason not given", "description": "Trans-abdominal or trans-vaginal ultrasound not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8808", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rh-immunoglobulin (rhogam) ordered", "description": "Rh-immunoglobulin (rhogam) ordered", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8809", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)", "description": "Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given", "description": "Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8811", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)", "description": "Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8815", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Statin medication prescribed at discharge", "description": "Statin medication prescribed at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8816", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Statin therapy not prescribed at discharge, reason not given", "description": "Statin therapy not prescribed at discharge, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8817", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient discharge to home no later than post-operative day #7", "description": "Patient discharge to home no later than post-operative day #7", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8818", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not discharged to home by post-operative day #7", "description": "Patient not discharged to home by post-operative day #7", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8825", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient discharge to home no later than post-operative day #2 following evar", "description": "Patient discharge to home no later than post-operative day #2 following evar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8826", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not discharged to home by post-operative day #2 following evar", "description": "Patient not discharged to home by post-operative day #2 following evar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8833", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient discharged to home no later than post-operative day #2 following cea", "description": "Patient discharged to home no later than post-operative day #2 following cea", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8834", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not discharged to home by post-operative day #2 following cea", "description": "Patient not discharged to home by post-operative day #2 following cea", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8838", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness", "description": "Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8839", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn't have initial daytime sleepiness, patient visited between initial testing and initiation of therapy)", "description": "Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn't have initial daytime sleepiness, patient visited between initial testing and initiation of therapy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sleep apnea symptoms not assessed, reason not given", "description": "Sleep apnea symptoms not assessed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8841", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) measured at the time of initial diagnosis", "description": "Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) measured at the time of initial diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8842", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason(s) for not measuring an apnea hypopnea index (ahi) or a respiratory disturbance index (rdi) at the time of initial diagnosis (e.g., psychiatric disease, dementia, patient declined, financial, insurance coverage, test ordered but not yet completed)", "description": "Documentation of reason(s) for not measuring an apnea hypopnea index (ahi) or a respiratory disturbance index (rdi) at the time of initial diagnosis (e.g., psychiatric disease, dementia, patient declined, financial, insurance coverage, test ordered but not yet completed)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8843", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) not measured at the time of initial diagnosis, reason not given", "description": "Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) not measured at the time of initial diagnosis, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8844", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positive airway pressure therapy prescribed", "description": "Positive airway pressure therapy prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8845", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Moderate or severe obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of 15 or greater)", "description": "Moderate or severe obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of 15 or greater)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8846", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)", "description": "Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8848", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)", "description": "Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8849", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positive airway pressure therapy not prescribed, reason not given", "description": "Positive airway pressure therapy not prescribed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Objective measurement of adherence to positive airway pressure therapy, documented", "description": "Objective measurement of adherence to positive airway pressure therapy, documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8851", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positive airway pressure therapy prescribed", "description": "Positive airway pressure therapy prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8852", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positive airway pressure therapy not prescribed", "description": "Positive airway pressure therapy not prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8853", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason(s) for not objectively measuring adherence to positive airway pressure therapy (e.g., patient didn't bring data from continous positive airway pressure [cpap], therapy not yet initiated, not available on machine)", "description": "Documentation of reason(s) for not objectively measuring adherence to positive airway pressure therapy (e.g., patient didn't bring data from continous positive airway pressure [cpap], therapy not yet initiated, not available on machine)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8854", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Objective measurement of adherence to positive airway pressure therapy not performed, reason not given", "description": "Objective measurement of adherence to positive airway pressure therapy not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8855", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Referral to a physician for an otologic evaluation performed", "description": "Referral to a physician for an otologic evaluation performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8856", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)", "description": "Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8857", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Referral to a physician for an otologic evaluation not performed, reason not given", "description": "Referral to a physician for an otologic evaluation not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8858", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days", "description": "Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8859", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days", "description": "Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8860", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed", "description": "Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8861", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days", "description": "Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8862", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients not assessed for risk of bone loss, reason not given", "description": "Patients not assessed for risk of bone loss, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8863", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumococcal vaccine administered or previously received", "description": "Pneumococcal vaccine administered or previously received", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8864", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)", "description": "Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8865", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)", "description": "Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8866", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumococcal vaccine not administered or previously received, reason not given", "description": "Pneumococcal vaccine not administered or previously received, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8867", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients receiving a first course of anti-tnf therapy", "description": "Patients receiving a first course of anti-tnf therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8868", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has documented immunity to hepatitis b and initiating anti-tnf therapy", "description": "Patient has documented immunity to hepatitis b and initiating anti-tnf therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8869", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy", "description": "Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8870", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not receiving a first course of anti-tnf therapy", "description": "Patient not receiving a first course of anti-tnf therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8871", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion", "description": "Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8872", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)", "description": "Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8873", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion", "description": "Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8874", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method", "description": "Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8875", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)", "description": "Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8876", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given", "description": "Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8877", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sentinel lymph node biopsy procedure performed", "description": "Sentinel lymph node biopsy procedure performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8878", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer", "description": "Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8879", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)", "description": "Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8880", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stage of breast cancer is greater than t1n0m0 or t2n0m0", "description": "Stage of breast cancer is greater than t1n0m0 or t2n0m0", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8881", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sentinel lymph node biopsy procedure not performed, reason not given", "description": "Sentinel lymph node biopsy procedure not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8882", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Biopsy results reviewed, communicated, tracked and documented", "description": "Biopsy results reviewed, communicated, tracked and documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8883", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented reason that patient's biopsy results were not reviewed", "description": "Clinician documented reason that patient's biopsy results were not reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8884", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Biopsy results not reviewed, communicated, tracked or documented", "description": "Biopsy results not reviewed, communicated, tracked or documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8885", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent blood pressure under control", "description": "Most recent blood pressure under control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8886", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for most recent blood pressure not being under control (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "description": "Documentation of medical reason(s) for most recent blood pressure not being under control (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8887", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent blood pressure not under control, results documented and reviewed", "description": "Most recent blood pressure not under control, results documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8888", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation of blood pressure measurement, reason not given", "description": "No documentation of blood pressure measurement, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8889", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent ldl-c under control, results documented and reviewed", "description": "Most recent ldl-c under control, results documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for most recent ldl-c not under control (e.g., patients with palliative goals for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "description": "Documentation of medical reason(s) for most recent ldl-c not under control (e.g., patients with palliative goals for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8891", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not performing ldl-c test (e.g. patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "description": "Documentation of medical reason(s) for not performing ldl-c test (e.g. patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8892", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent ldl-c not under control, results documented and reviewed", "description": "Most recent ldl-c not under control, results documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8893", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ldl-c not performed, reason not given", "description": "Ldl-c not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8894", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral aspirin or other antithrombotic therapy prescribed", "description": "Oral aspirin or other antithrombotic therapy prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8895", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not prescribing oral aspirin or other antithrombotic therapy (e.g., patient documented to be low risk or patient with terminal illness or treatment of hypertension with standard treatment goals is not clinically appropriate, or for whom risk of aspirin or other antithrombotic therapy exceeds potential benefits such as for individuals whose blood pressure is poorly controlled)", "description": "Documentation of medical reason(s) for not prescribing oral aspirin or other antithrombotic therapy (e.g., patient documented to be low risk or patient with terminal illness or treatment of hypertension with standard treatment goals is not clinically appropriate, or for whom risk of aspirin or other antithrombotic therapy exceeds potential benefits such as for individuals whose blood pressure is poorly controlled)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8896", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral aspirin or other antithrombotic therapy was not prescribed, reason not given", "description": "Oral aspirin or other antithrombotic therapy was not prescribed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8897", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the chronic obstructive pulmonary disease (copd) measures group", "description": "I intend to report the chronic obstructive pulmonary disease (copd) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8898", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the inflammatory bowel disease (ibd) measures group", "description": "I intend to report the inflammatory bowel disease (ibd) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8899", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the sleep apnea measures group", "description": "I intend to report the sleep apnea measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the dementia measures group", "description": "I intend to report the dementia measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8902", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the parkinson's disease measures group", "description": "I intend to report the parkinson's disease measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8903", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the hypertension (htn) measures group", "description": "I intend to report the hypertension (htn) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8904", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the cardiovascular prevention measures group", "description": "I intend to report the cardiovascular prevention measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8905", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the cataract measures group", "description": "I intend to report the cataract measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8906", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility", "description": "Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8907", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented to have received a burn prior to discharge", "description": "Patient documented to have received a burn prior to discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8908", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented not to have received a burn prior to discharge", "description": "Patient documented not to have received a burn prior to discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8909", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented to have experienced a fall within asc", "description": "Patient documented to have experienced a fall within asc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented not to have experienced a fall within ambulatory surgical center", "description": "Patient documented not to have experienced a fall within ambulatory surgical center", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8911", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event", "description": "Patient documented to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8912", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event", "description": "Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8913", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented to have experienced a hospital transfer or hospital admission upon discharge from asc", "description": "Patient documented to have experienced a hospital transfer or hospital admission upon discharge from asc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8914", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from asc", "description": "Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from asc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8915", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time", "description": "Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8916", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic not initiated on time", "description": "Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic not initiated on time", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8917", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis", "description": "Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8918", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Left ventricular ejection fraction (lvef) < 40% or documentation of moderately or severely depressed left ventricular systolic function", "description": "Left ventricular ejection fraction (lvef) < 40% or documentation of moderately or severely depressed left ventricular systolic function", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8923", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spirometry test results demonstrate fev1/fvc < 70%, fev1 < 60% predicted and patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)", "description": "Spirometry test results demonstrate fev1/fvc < 70%, fev1 < 60% predicted and patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8924", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms", "description": "Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8925", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spirometry test not performed or documented, reason not given", "description": "Spirometry test not performed or documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8926", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer", "description": "Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8927", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)", "description": "Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8928", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adjuvant chemotherapy not prescribed or previously received, reason not given", "description": "Adjuvant chemotherapy not prescribed or previously received, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8929", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assessment of depression severity at the initial evaluation", "description": "Assessment of depression severity at the initial evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assessment of depression severity not documented, reason not given", "description": "Assessment of depression severity not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8931", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Suicide risk assessed at the initial evaluation", "description": "Suicide risk assessed at the initial evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8932", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Suicide risk not assessed at the initial evaluation, reason not given", "description": "Suicide risk not assessed at the initial evaluation, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8933", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Left ventricular ejection fraction (lvef) <40% or documentation of moderately or severely depressed left ventricular systolic function", "description": "Left ventricular ejection fraction (lvef) <40% or documentation of moderately or severely depressed left ventricular systolic function", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8934", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy", "description": "Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8935", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (eg, patient declined, other patient reasons) or (eg, lack of drug availability, other reasons attributable to the health care system)", "description": "Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (eg, patient declined, other patient reasons) or (eg, lack of drug availability, other reasons attributable to the health care system)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8936", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given", "description": "Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8937", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible", "description": "Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8938", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter", "description": "Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8939", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening for depression documented as positive, a follow-up plan not completed, documented reason", "description": "Screening for depression documented as positive, a follow-up plan not completed, documented reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounter", "description": "Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8941", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional outcomes assessment using a standardized tool is documented within the previous 30 days and care plan, based on identified deficiencies on the date of the functional outcome assessment, is documented", "description": "Functional outcomes assessment using a standardized tool is documented within the previous 30 days and care plan, based on identified deficiencies on the date of the functional outcome assessment, is documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8942", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ldl-c result not present or not within 12 months prior", "description": "Ldl-c result not present or not within 12 months prior", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8943", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ajcc melanoma cancer stage 0 through iic melanoma", "description": "Ajcc melanoma cancer stage 0 through iic melanoma", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8944", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)", "description": "Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8946", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "One or more neuropsychiatric symptoms", "description": "One or more neuropsychiatric symptoms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8947", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No neuropsychiatric symptoms", "description": "No neuropsychiatric symptoms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8948", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes)", "description": "Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8949", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pre-hypertensive or hypertensive blood pressure reading documented, and the indicated follow-up is documented", "description": "Pre-hypertensive or hypertensive blood pressure reading documented, and the indicated follow-up is documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligible", "description": "Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligible", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8951", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given", "description": "Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8952", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the oncology measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the oncology measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8953", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent assessment of adequacy of volume management documented", "description": "Most recent assessment of adequacy of volume management documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8955", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving maintenance hemodialysis in an outpatient dialysis facility", "description": "Patient receiving maintenance hemodialysis in an outpatient dialysis facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8956", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not receiving maintenance hemodialysis in an outpatient dialysis facility", "description": "Patient not receiving maintenance hemodialysis in an outpatient dialysis facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8957", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assessment of adequacy of volume management not documented, reason not given", "description": "Assessment of adequacy of volume management not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8958", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician treating major depressive disorder communicates to clinician treating comorbid condition", "description": "Clinician treating major depressive disorder communicates to clinician treating comorbid condition", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8959", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given", "description": "Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery", "description": "Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8961", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac stress imaging test performed on patient for any reason including those who did not have low risk surgery or test that was performed more than 30 days preceding low risk surgery", "description": "Cardiac stress imaging test performed on patient for any reason including those who did not have low risk surgery or test that was performed more than 30 days preceding low risk surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8962", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years", "description": "Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8963", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)", "description": "Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8964", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment", "description": "Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8965", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment", "description": "Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8966", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Warfarin or another fda approved oral anticoagulant is prescribed", "description": "Warfarin or another fda approved oral anticoagulant is prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8967", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not prescribing warfarin or another fda-approved anticoagulant (e.g., atrial appendage device in place)", "description": "Documentation of medical reason(s) for not prescribing warfarin or another fda-approved anticoagulant (e.g., atrial appendage device in place)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8968", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not prescribing warfarin or another oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient choice of having atrial appendage device placed)", "description": "Documentation of patient reason(s) for not prescribing warfarin or another oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient choice of having atrial appendage device placed)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8969", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No risk factors or one moderate risk factor for thromboembolism", "description": "No risk factors or one moderate risk factor for thromboembolism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given", "description": "Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8971", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism", "description": "One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8972", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent hemoglobin (hgb) level < 10 g/dl", "description": "Most recent hemoglobin (hgb) level < 10 g/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8973", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemoglobin level measurement not documented, reason not given", "description": "Hemoglobin level measurement not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8974", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)", "description": "Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8975", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent hemoglobin (hgb) level >= 10 g/dl", "description": "Most recent hemoglobin (hgb) level >= 10 g/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8976", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the oncology measures group", "description": "I intend to report the oncology measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8977", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals", "description": "Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8978", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8979", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals", "description": "Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8981", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8983", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals", "description": "Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8984", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8985", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8986", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Self care functional limitation, current status, at therapy episode outset and at reporting intervals", "description": "Self care functional limitation, current status, at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8987", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8988", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Self care functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Self care functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8989", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals", "description": "Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8990", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8991", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8992", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals", "description": "Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8993", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8994", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8995", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Swallowing functional limitation, current status at therapy episode outset and at reporting intervals", "description": "Swallowing functional limitation, current status at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8996", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8997", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8998", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Motor speech functional limitation, current status at therapy episode outset and at reporting intervals", "description": "Motor speech functional limitation, current status at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G8999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, initial rate", "description": "Coordinated care fee, initial rate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, maintenance rate", "description": "Coordinated care fee, maintenance rate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, risk adjusted high, initial", "description": "Coordinated care fee, risk adjusted high, initial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, risk adjusted low, initial", "description": "Coordinated care fee, risk adjusted low, initial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, risk adjusted maintenance", "description": "Coordinated care fee, risk adjusted maintenance", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, home monitoring", "description": "Coordinated care fee, home monitoring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, scheduled team conference", "description": "Coordinated care fee, scheduled team conference", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, physician coordinated care oversight services", "description": "Coordinated care fee, physician coordinated care oversight services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, risk adjusted maintenance, level 3", "description": "Coordinated care fee, risk adjusted maintenance, level 3", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, risk adjusted maintenance, level 4", "description": "Coordinated care fee, risk adjusted maintenance, level 4", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coordinated care fee, risk adjusted maintenance, level 5", "description": "Coordinated care fee, risk adjusted maintenance, level 5", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other specified case management service not elsewhere classified", "description": "Other specified case management service not elsewhere classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Esrd demo basic bundle level i", "description": "Esrd demo basic bundle level i", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Esrd demo expanded bundle including venous access and related services", "description": "Esrd demo expanded bundle including venous access and related services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only]", "description": "Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only]", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)", "description": "Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project)", "description": "Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)", "description": "Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)", "description": "Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)", "description": "Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project)", "description": "Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)", "description": "Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)", "description": "Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; primary focus of visit; work-up, evaluation, or staging at the time of cancer diagnosis or recurrence (for use in a medicare-approved demonstration project)", "description": "Oncology; primary focus of visit; work-up, evaluation, or staging at the time of cancer diagnosis or recurrence (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; primary focus of visit; treatment decision-making after disease is staged or restaged, discussion of treatment options, supervising/coordinating active cancer directed therapy or managing consequences of cancer directed therapy (for use in a medicare-approved demonstration project)", "description": "Oncology; primary focus of visit; treatment decision-making after disease is staged or restaged, discussion of treatment options, supervising/coordinating active cancer directed therapy or managing consequences of cancer directed therapy (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9051", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; primary focus of visit; surveillance for disease recurrence for patient who has completed definitive cancer-directed therapy and currently lacks evidence of recurrent disease; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)", "description": "Oncology; primary focus of visit; surveillance for disease recurrence for patient who has completed definitive cancer-directed therapy and currently lacks evidence of recurrent disease; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; primary focus of visit; expectant management of patient with evidence of cancer for whom no cancer directed therapy is being administered or arranged at present; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)", "description": "Oncology; primary focus of visit; expectant management of patient with evidence of cancer for whom no cancer directed therapy is being administered or arranged at present; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9053", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a medicare-approved demonstration project)", "description": "Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9054", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)", "description": "Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)", "description": "Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9056", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; practice guidelines; management differs from guidelines as a result of patient enrollment in an institutional review board approved clinical trial (for use in a medicare-approved demonstration project)", "description": "Oncology; practice guidelines; management differs from guidelines as a result of patient enrollment in an institutional review board approved clinical trial (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9057", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; practice guidelines; management differs from guidelines because the treating physician disagrees with guideline recommendations (for use in a medicare-approved demonstration project)", "description": "Oncology; practice guidelines; management differs from guidelines because the treating physician disagrees with guideline recommendations (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9058", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; practice guidelines; management differs from guidelines because the patient, after being offered treatment consistent with guidelines, has opted for alternative treatment or management, including no treatment (for use in a medicare-approved demonstration project)", "description": "Oncology; practice guidelines; management differs from guidelines because the patient, after being offered treatment consistent with guidelines, has opted for alternative treatment or management, including no treatment (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9059", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; practice guidelines; management differs from guidelines for reason(s) associated with patient comorbid illness or performance status not factored into guidelines (for use in a medicare-approved demonstration project)", "description": "Oncology; practice guidelines; management differs from guidelines for reason(s) associated with patient comorbid illness or performance status not factored into guidelines (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)", "description": "Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9061", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9062", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage i (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage i (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9063", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage ii (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage ii (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9064", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage iii a (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage iii a (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9065", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to non-small cell lung cancer; stage iii b- iv at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to non-small cell lung cancer; stage iii b- iv at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9066", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to non-small cell lung cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to non-small cell lung cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9067", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9068", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small cell; extensive stage at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small cell; extensive stage at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9069", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i or stage iia-iib; or t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i or stage iia-iib; or t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9071", 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medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9072", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9073", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9074", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9075", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t1-t2c and gleason 2-7 and psa < or equal to 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cell type; t2 or t3a gleason 8-10 or psa > 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t2 or t3a gleason 8-10 or psa > 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9078", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t3b-t4, any n; any t, n1 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t3b-t4, any n; any t, n1 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9079", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; prostate cancer, limited to adenocarcinoma; after initial treatment with rising psa or failure of psa decline (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; prostate cancer, limited to adenocarcinoma; after initial treatment with rising psa or failure of psa decline (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; prostate cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; prostate cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9084", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t4, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t4, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9085", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-4, n1-2, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-4, n1-2, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9086", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive with current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive with current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9087", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive without current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive without current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9088", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9089", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% 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"billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9091", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n1-2, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n1-2, m0 (prior to neo-adjuvant therapy, if any) 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"11" ] } ] } ] }, { "name": "Oncology; disease status; pancreatic cancer, limited to adenocarcinoma as predominant cell type; post r0 resection without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; pancreatic cancer, limited to adenocarcinoma as predominant cell type; post r0 resection without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": 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and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease initially established as t3-4 and/or n1-3, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease initially established as t3-4 and/or n1-3, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9111", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], 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"percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage ia-b (grade 2-3); or stage ic (all grades); or stage ii; without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage ia-b (grade 2-3); or stage ic (all grades); or stage ii; without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9114", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], 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charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; ovarian cancer, limited to epithelial cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; ovarian cancer, limited to epithelial cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; chronic phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; chronic phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9123", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; accelerated phase not in hematologic cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; accelerated phase not in hematologic cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9124", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; blast phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; blast phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9125", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to multiple myeloma, systemic disease; smoldering, stage i (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to multiple myeloma, systemic disease; smoldering, stage i (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9128", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to multiple myeloma, systemic disease; stage ii or higher (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to multiple myeloma, systemic disease; stage ii or higher (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9129", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; limited to multiple myeloma, systemic disease; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; limited to multiple myeloma, systemic disease; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-refractory/androgen-independent (e.g., rising psa on anti-androgen therapy or post-orchiectomy); clinical metastases (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-refractory/androgen-independent (e.g., rising psa on anti-androgen therapy or post-orchiectomy); clinical metastases (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9132", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-responsive; clinical metastases or m1 at diagnosis (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-responsive; clinical metastases or m1 at diagnosis (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9133", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; stage i, ii at diagnosis, not relapsed, not refractory (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; stage i, ii at diagnosis, not relapsed, not refractory (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9134", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; stage iii, iv, not relapsed, not refractory (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; stage iii, iv, not relapsed, not refractory (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9135", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; non-hodgkin's lymphoma, transformed from original cellular diagnosis to a second cellular classification (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; non-hodgkin's lymphoma, transformed from original cellular diagnosis to a second cellular classification (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9136", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; relapsed/refractory (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; relapsed/refractory (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9137", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; diagnostic evaluation, stage not determined, evaluation of possible relapse or non-response to therapy, or not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; non-hodgkin's lymphoma, any cellular classification; diagnostic evaluation, stage not determined, evaluation of possible relapse or non-response to therapy, or not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9138", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; extent of disease unknown, staging in progress, not listed (for use in a medicare-approved demonstration project)", "description": "Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; extent of disease unknown, staging in progress, not listed (for use in a medicare-approved demonstration project)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9139", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Frontier extended stay clinic demonstration; for a patient stay in a clinic approved for the cms demonstration project; the following measures should be present: the stay must be equal to or greater than 4 hours; weather or other conditions must prevent transfer or the case falls into a category of monitoring and observation cases that are permitted by the rules of the demonstration; there is a maximum frontier extended stay clinic (fesc) visit of 48 hours, except in the case when weather or other conditions prevent transfer; payment is made on each period up to 4 hours, after the first 4 hours", "description": "Frontier extended stay clinic demonstration; for a patient stay in a clinic approved for the cms demonstration project; the following measures should be present: the stay must be equal to or greater than 4 hours; weather or other conditions must prevent transfer or the case falls into a category of monitoring and observation cases that are permitted by the rules of the demonstration; there is a maximum frontier extended stay clinic (fesc) visit of 48 hours, except in the case when weather or other conditions prevent transfer; payment is made on each period up to 4 hours, after the first 4 hours", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)", "description": "Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9143", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Outpatient intravenous insulin treatment (oivit) either pulsatile or continuous, by any means, guided by the results of measurements for: respiratory quotient; and/or, urine urea nitrogen (uun); and/or, arterial, venous or capillary glucose; and/or potassium concentration", "description": "Outpatient intravenous insulin treatment (oivit) either pulsatile or continuous, by any means, guided by the results of measurements for: respiratory quotient; and/or, urine urea nitrogen (uun); and/or, arterial, venous or capillary glucose; and/or potassium concentration", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9147", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "National committee for quality assurance - level 1 medical home", "description": "National committee for quality assurance - level 1 medical home", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9148", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "National committee for quality assurance - level 2 medical home", "description": "National committee for quality assurance - level 2 medical home", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9149", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "National committee for quality assurance - level 3 medical home", "description": "National committee for quality assurance - level 3 medical home", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mapcp demonstration - state provided services", "description": "Mapcp demonstration - state provided services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9151", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mapcp demonstration - community health teams", "description": "Mapcp demonstration - community health teams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9152", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mapcp demonstration - physician incentive pool", "description": "Mapcp demonstration - physician incentive pool", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Evaluation for wheelchair requiring face to face visit with physician", "description": "Evaluation for wheelchair requiring face to face visit with physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9156", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes", "description": "Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9157", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9158", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals", "description": "Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9159", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting", "description": "Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals", "description": "Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9163", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting", "description": "Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9164", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Attention functional limitation, current status at therapy episode outset and at reporting intervals", "description": "Attention functional limitation, current status at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9165", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9166", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Attention functional limitation, discharge status at discharge from therapy or to end reporting", "description": "Attention functional limitation, discharge status at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9167", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Memory functional limitation, current status at therapy episode outset and at reporting intervals", "description": "Memory functional limitation, current status at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9168", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9169", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Memory functional limitation, discharge status at discharge from therapy or to end reporting", "description": "Memory functional limitation, discharge status at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Voice functional limitation, current status at therapy episode outset and at reporting intervals", "description": "Voice functional limitation, current status at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9172", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Voice functional limitation, discharge status at discharge from therapy or to end reporting", "description": "Voice functional limitation, discharge status at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9173", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals", "description": "Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9174", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting", "description": "Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9176", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "description": "Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code", "description": "Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9187", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Beta-blocker therapy not prescribed, reason not given", "description": "Beta-blocker therapy not prescribed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9188", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Beta-blocker therapy prescribed or currently being taken", "description": "Beta-blocker therapy prescribed or currently being taken", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9189", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)", "description": "Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)", "description": "Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9191", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)", "description": "Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9192", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression", "description": "Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9193", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase", "description": "Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9194", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase", "description": "Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9195", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))", "description": "Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9196", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis", "description": "Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9197", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given", "description": "Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9198", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))", "description": "Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given", "description": "Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission", "description": "Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with a positive hepatitis c antibody test", "description": "Patients with a positive hepatitis c antibody test", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c", "description": "Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given", "description": "Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient starting antiviral treatmentfor hepatitis c during the measurement period", "description": "Patient starting antiviral treatmentfor hepatitis c during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient starting antiviral treatment for hepatitis c during the measurement period", "description": "Patient starting antiviral treatment for hepatitis c during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c", "description": "Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given", "description": "Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment", "description": "Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)", "description": "Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given", "description": "Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation", "description": "Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified", "description": "Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cd4+ cell count or cd4+ cell percentage results documented", "description": "Cd4+ cell count or cd4+ cell percentage results documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cd4+ cell count or percentage not documented as performed, reason not given", "description": "Cd4+ cell count or percentage not documented as performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given", "description": "Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given", "description": "Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9217", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given", "description": "Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9218", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)", "description": "Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9219", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)", "description": "Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumocystis jiroveci pneumonia prophlaxis prescribed", "description": "Pneumocystis jiroveci pneumonia prophlaxis prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3", "description": "Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%", "description": "Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9223", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)", "description": "Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9224", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot exam was not performed, reason not given", "description": "Foot exam was not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)", "description": "Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9226", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter", "description": "Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9227", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)", "description": "Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9228", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)", "description": "Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9229", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chlamydia, gonorrhea, and syphilis not screened, reason not given", "description": "Chlamydia, gonorrhea, and syphilis not screened, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period", "description": "Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9231", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)", "description": "Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9232", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9233", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the total knee replacement measures group", "description": "I intend to report the total knee replacement measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9234", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the general surgery measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the general surgery measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9235", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9236", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the general surgery measures group", "description": "I intend to report the general surgery measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9237", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the optimizing patient exposure to ionizing radiation measures group", "description": "I intend to report the optimizing patient exposure to ionizing radiation measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9238", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reasons for patient initiating maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing arteriovenous fistula (avf)/arteriovenous graft (avg), time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)", "description": "Documentation of reasons for patient initiating maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing arteriovenous fistula (avf)/arteriovenous graft (avg), time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9239", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated", "description": "Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated", "description": "Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9241", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed", "description": "Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9242", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of viral load less than 200 copies/ml", "description": "Documentation of viral load less than 200 copies/ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9243", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antiretroviral thereapy not prescribed", "description": "Antiretroviral thereapy not prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9244", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antiretroviral therapy prescribed", "description": "Antiretroviral therapy prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not have at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits", "description": "Patient did not have at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits", "description": "Patient had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not have a medical visit in the last 6 months", "description": "Patient did not have a medical visit in the last 6 months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had a medical visit in the last 6 months", "description": "Patient had a medical visit in the last 6 months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9249", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment", "description": "Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment", "description": "Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9251", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adenoma(s) or other neoplasm detected during screening colonoscopy", "description": "Adenoma(s) or other neoplasm detected during screening colonoscopy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9252", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adenoma(s) or other neoplasm not detected during screening colonoscopy", "description": "Adenoma(s) or other neoplasm not detected during screening colonoscopy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9253", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient discharged to home later than post-operative day 2 following cas", "description": "Documentation of patient discharged to home later than post-operative day 2 following cas", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9254", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient discharged to home no later than post operative day 2 following cas", "description": "Documentation of patient discharged to home no later than post operative day 2 following cas", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient death following cas", "description": "Documentation of patient death following cas", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9256", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient stroke following cas", "description": "Documentation of patient stroke following cas", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient stroke following cea", "description": "Documentation of patient stroke following cea", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9258", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient survival and absence of stroke following cas", "description": "Documentation of patient survival and absence of stroke following cas", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9259", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient death following cea", "description": "Documentation of patient death following cea", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient survival and absence of stroke following cea", "description": "Documentation of patient survival and absence of stroke following cea", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9261", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient death in the hospital following endovascular aaa repair", "description": "Documentation of patient death in the hospital following endovascular aaa repair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9262", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient discharged alive following endovascular aaa repair", "description": "Documentation of patient discharged alive following endovascular aaa repair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9263", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons)", "description": "Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9264", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access", "description": "Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access", "description": "Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9266", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient with one or more complications or mortality within 30 days", "description": "Documentation of patient with one or more complications or mortality within 30 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9267", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient with one or more complications within 90 days", "description": "Documentation of patient with one or more complications within 90 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9268", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient without one or more complications and without mortality within 30 days", "description": "Documentation of patient without one or more complications and without mortality within 30 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9269", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient without one or more complications within 90 days", "description": "Documentation of patient without one or more complications within 90 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ldl value < 100", "description": "Ldl value < 100", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9271", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ldl value >= 100", "description": "Ldl value >= 100", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9272", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood pressure has a systolic value of < 140 and a diastolic value of < 90", "description": "Blood pressure has a systolic value of < 140 and a diastolic value of < 90", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9273", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90", "description": "Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9274", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that patient is a current non-tobacco user", "description": "Documentation that patient is a current non-tobacco user", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that patient is a current tobacco user", "description": "Documentation that patient is a current tobacco user", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9276", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)", "description": "Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9277", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that the patient is not on daily aspirin or anti-platelet regimen", "description": "Documentation that the patient is not on daily aspirin or anti-platelet regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9278", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumococcal screening performed and documentation of vaccination received prior to discharge", "description": "Pneumococcal screening performed and documentation of vaccination received prior to discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9279", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumococcal vaccination not administered prior to discharge, reason not specified", "description": "Pneumococcal vaccination not administered prior to discharge, reason not specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening performed and documentation that vaccination not indicated/patient refusal", "description": "Screening performed and documentation that vaccination not indicated/patient refusal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9281", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)", "description": "Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9282", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation", "description": "Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9283", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation", "description": "Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9284", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer", "description": "Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antibiotic regimen prescribed within 10 days after onset of symptoms", "description": "Antibiotic regimen prescribed within 10 days after onset of symptoms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9286", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antibiotic regimen not prescribed within 10 days after onset of symptoms", "description": "Antibiotic regimen not prescribed within 10 days after onset of symptoms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9287", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)", "description": "Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9288", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation", "description": "Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9289", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation", "description": "Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos", "description": "Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9291", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)", "description": "Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9292", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate", "description": "Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9293", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate", "description": "Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9294", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site other than anatomic cutaneous location", "description": "Specimen site other than anatomic cutaneous location", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9295", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure", "description": "Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9296", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure, not documented, reason not given", "description": "Shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure, not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9297", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke)", "description": "Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9298", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke, reason not given)", "description": "Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke, reason not given)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9299", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)", "description": "Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet", "description": "Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given", "description": "Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9302", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given", "description": "Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9303", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant", "description": "Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9304", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intervention for presence of leak of endoluminal contents through an anastomosis not required", "description": "Intervention for presence of leak of endoluminal contents through an anastomosis not required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9305", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intervention for presence of leak of endoluminal contents through an anastomosis required", "description": "Intervention for presence of leak of endoluminal contents through an anastomosis required", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9306", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure", "description": "No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9307", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure", "description": "Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9308", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No unplanned hospital readmission within 30 days of principal procedure", "description": "No unplanned hospital readmission within 30 days of principal procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9309", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unplanned hospital readmission within 30 days of principal procedure", "description": "Unplanned hospital readmission within 30 days of principal procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No surgical site infection", "description": "No surgical site infection", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9311", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical site infection", "description": "Surgical site infection", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9312", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason", "description": "Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9313", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given", "description": "Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9314", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis", "description": "Documentation amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family", "description": "Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9316", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family not completed", "description": "Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family not completed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9317", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Imaging study named according to standardized nomenclature", "description": "Imaging study named according to standardized nomenclature", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9318", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Imaging study not named according to standardized nomenclature, reason not given", "description": "Imaging study not named according to standardized nomenclature, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9319", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "description": "Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion) studies documented in the 12-month period prior to the current study", "description": "Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion) studies documented in the 12-month period prior to the current study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9321", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Count of previous ct and cardiac nuclear medicine (myocardial perfusion) studies not documented in the 12-month period prior to the current study, reason not given", "description": "Count of previous ct and cardiac nuclear medicine (myocardial perfusion) studies not documented in the 12-month period prior to the current study, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9322", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "description": "Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9323", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All necessary data elements not included, reason not given", "description": "All necessary data elements not included, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9324", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ct studies not reported to a radiation dose index registry due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "description": "Ct studies not reported to a radiation dose index registry due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ct studies performed not reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements, reason not given", "description": "Ct studies performed not reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9326", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements", "description": "Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9327", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dicom format image data availability not documented in final report due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "description": "Dicom format image data availability not documented in final report due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9328", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given", "description": "Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9329", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final report documented that dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study", "description": "Final report documented that dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Search conducted for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed", "description": "Search conducted for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9341", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Search not conducted prior to an imaging study being performed for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive, reason not given", "description": "Search not conducted prior to an imaging study being performed for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9342", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Due to medical reasons, search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "description": "Due to medical reasons, search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9343", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Due to system reasons search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., non-affiliated external healthcare facilities or entities does not have archival abilities through a shared archival system)", "description": "Due to system reasons search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., non-affiliated external healthcare facilities or entities does not have archival abilities through a shared archival system)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9344", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Follow-up recommendations documented according to recommended guidelines for incidentally detected pulmonary nodules (e.g., follow-up ct imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factors", "description": "Follow-up recommendations documented according to recommended guidelines for incidentally detected pulmonary nodules (e.g., follow-up ct imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factors", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9345", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules due to medical reasons (e.g., patients with known malignant disease, patients with unexplained fever, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "description": "Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules due to medical reasons (e.g., patients with known malignant disease, patients with unexplained fever, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9346", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules, reason not given", "description": "Follow-up 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"negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis", "description": "Ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9349", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis", "description": "Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "More than one ct scan of the paranasal sinuses ordered or received within 90 days after diagnosis", "description": "More than one ct scan of the paranasal sinuses ordered or received within 90 days after diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9351", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given", "description": "More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9352", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (eg, patients with complications, second ct obtained prior to surgery, other medical reasons)", "description": "More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (eg, patients with complications, second ct obtained prior to surgery, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9353", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis", "description": "One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9354", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Early elective delivery by c-section, or early elective induction, not performed (less than 39 weeks gestation)", "description": "Early elective delivery by c-section, or early elective induction, not performed (less than 39 weeks gestation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9355", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Early elective delivery by c-section, or early elective induction, performed (less than 39 week gestation)", "description": "Early elective delivery by c-section, or early elective induction, performed (less than 39 week gestation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9356", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Post-partum screenings, evaluations and education performed", "description": "Post-partum screenings, evaluations and education performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9357", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Post-partum screenings, evaluations and education not performed", "description": "Post-partum screenings, evaluations and education not performed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9358", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to the treatment with a biologic immune response modifier", "description": "Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to the treatment with a biologic immune response modifier", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9359", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation of negative or managed positive tb screen", "description": "No documentation of negative or managed positive tb screen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical indication for induction [documentation of reason(s) for elective delivery (c-section) or early induction (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes-premature or prolonged, maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]", "description": "Medical indication for induction [documentation of reason(s) for elective delivery (c-section) or early induction (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes-premature or prolonged, maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9361", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia record", "description": "Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9362", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia record", "description": "Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9363", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sinusitis caused by, or presumed to be caused by, bacterial infection", "description": "Sinusitis caused by, or presumed to be caused by, bacterial infection", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "One high-risk medication ordered", "description": "One high-risk medication ordered", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9365", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "One high-risk medication not ordered", "description": "One high-risk medication not ordered", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9366", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "At least two orders for the same high-risk medication", "description": "At least two orders for the same high-risk medication", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9367", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "At least two orders for the same high-risk medications not ordered", "description": "At least two orders for the same high-risk medications not ordered", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9368", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater", "description": "Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9369", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater", "description": "Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery", "description": "Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9376", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not have the retina attached after 6 months following only one surgery", "description": "Patient did not have the retina attached after 6 months following only one surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9377", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)", "description": "Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9378", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not achieve flat retinas six months post surgery", "description": "Patient did not achieve flat retinas six months post surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9379", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient offered assistance with end of life issues during the measurement period", "description": "Patient offered assistance with end of life issues during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement period", "description": "Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9381", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not offered assistance with end of life issues during the measurement period", "description": "Patient not offered assistance with end of life issues during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9382", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received screening for hcv infection within the 12 month reporting period", "description": "Patient received screening for hcv infection within the 12 month reporting period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9383", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not receiving annual screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)", "description": "Documentation of medical reason(s) for not receiving annual screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9384", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not receiving annual screening for hcv infection (e.g., patient declined, other patient reasons)", "description": "Documentation of patient reason(s) for not receiving annual screening for hcv infection (e.g., patient declined, other patient reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9385", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening for hcv infection not received within the 12 month reporting period, reason not given", "description": "Screening for hcv infection not received within the 12 month reporting period, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9386", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery", "description": "Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9389", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery", "description": "No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit", "description": "Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9391", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit", "description": "Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9392", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with an initial phq-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score of less than five", "description": "Patient with an initial phq-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score of less than five", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9393", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period", "description": "Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9394", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five", "description": "Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9395", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)", "description": "Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9396", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment", "description": "Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9399", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons", "description": "Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment", "description": "No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9401", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received follow-up within 30 days after discharge", "description": "Patient received follow-up within 30 days after discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9402", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)", "description": "Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9403", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive follow-up on the date of discharge or within 30 days after discharge", "description": "Patient did not receive follow-up on the date of discharge or within 30 days after discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9404", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received follow-up within 7 days after discharge", "description": "Patient received follow-up within 7 days after discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9405", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)", "description": "Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9406", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive follow-up on or within 7 days after discharge", "description": "Patient did not receive follow-up on or within 7 days after discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9407", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days", "description": "Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9408", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days", "description": "Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9409", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision", "description": "Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision", "description": "Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9411", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision", "description": "Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9412", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision", "description": "Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9413", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays", "description": "Patient had one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9414", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not have one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays", "description": "Patient did not have one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient's 11th and 13th birthdays", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9415", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays", "description": "Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9416", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays", "description": "Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9417", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation", "description": "Primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9418", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of primary non-small cell lung cancer or other documented medical reasons)", "description": "Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of primary non-small cell lung cancer or other documented medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9419", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer", "description": "Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Primary non-small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation", "description": "Primary non-small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9421", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma and not nsclc-nos)", "description": "Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma and not nsclc-nos)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9422", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]", "description": "Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9423", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site other than anatomic location of lung, or classified as nsclc-nos", "description": "Specimen site other than anatomic location of lung, or classified as nsclc-nos", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9424", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma)", "description": "Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9425", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients", "description": "Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9426", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients", "description": "Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9427", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathology report includes the pt category and a statement on thickness, ulceration and mitotic rate", "description": "Pathology report includes the pt category and a statement on thickness, ulceration and mitotic rate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9428", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not including pt category and a statement on thickness, ulceration and mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)", "description": "Documentation of medical reason(s) for not including pt category and a statement on thickness, ulceration and mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9429", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specimen site other than anatomic cutaneous location", "description": "Specimen site other than anatomic cutaneous location", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathology report does not include the pt category and a statement on thickness, ulceration and mitotic rate", "description": "Pathology report does not include the pt category and a statement on thickness, ulceration and mitotic rate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9431", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented", "description": "Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9432", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period", "description": "Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9433", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not given", "description": "Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9434", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aspirin prescribed at discharge", "description": "Aspirin prescribed at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9435", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)", "description": "Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9436", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aspirin not prescribed at discharge", "description": "Aspirin not prescribed at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9437", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "P2y inhibitor prescribed at discharge", "description": "P2y inhibitor prescribed at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9438", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)", "description": "P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9439", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "P2y inhibitor not prescribed at discharge", "description": "P2y inhibitor not prescribed at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9440", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Statin prescribed at discharge", "description": "Statin prescribed at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9441", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)", "description": "Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9442", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Statin not prescribed at discharge", "description": "Statin not prescribed at discharge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9443", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who were born in the years 1945 to 1965", "description": "Patients who were born in the years 1945 to 1965", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9448", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "History of receiving blood transfusions prior to 1992", "description": "History of receiving blood transfusions prior to 1992", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9449", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "History of injection drug use", "description": "History of injection drug use", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received one-time screening for hcv infection", "description": "Patient received one-time screening for hcv infection", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9451", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not receiving one-time screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [ie, ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)", "description": "Documentation of medical reason(s) for not receiving one-time screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [ie, ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons)", "description": "Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9453", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given", "description": "One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9454", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient underwent abdominal imaging with ultrasound, contrast enhanced ct or contrast mri for hcc", "description": "Patient underwent abdominal imaging with ultrasound, contrast enhanced ct or contrast mri for hcc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical or patient reason(s) for not ordering or performing screening for hcc. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment)", "description": "Documentation of medical or patient reason(s) for not ordering or performing screening for hcc. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9456", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period", "description": "Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9457", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user", "description": "Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9458", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Currently a tobacco non-user", "description": "Currently a tobacco non-user", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9459", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tobacco assessment or tobacco cessation intervention not performed, reason not given", "description": "Tobacco assessment or tobacco cessation intervention not performed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the sinusitis measures group", "description": "I intend to report the sinusitis measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9463", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9464", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the acute otitis externa (aoe) measures group", "description": "I intend to report the acute otitis externa (aoe) measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the aoe measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the aoe measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9466", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months", "description": "Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9467", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills", "description": "Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9468", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fills", "description": "Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fills", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9469", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills", "description": "Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented", "description": "Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9471", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed", "description": "Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9472", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by chaplain in the hospice setting, each 15 minutes", "description": "Services performed by chaplain in the hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9473", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by dietary counselor in the hospice setting, each 15 minutes", "description": "Services performed by dietary counselor in the hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9474", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by other counselor in the hospice setting, each 15 minutes", "description": "Services performed by other counselor in the hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9475", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by volunteer in the hospice setting, each 15 minutes", "description": "Services performed by volunteer in the hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9476", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by care coordinator in the hospice setting, each 15 minutes", "description": "Services performed by care coordinator in the hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9477", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by other qualified therapist in the hospice setting, each 15 minutes", "description": "Services performed by other qualified therapist in the hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9478", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services performed by qualified pharmacist in the hospice setting, each 15 minutes", "description": "Services performed by qualified pharmacist in the hospice setting, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9479", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Admission to medicare care choice model program (mccm)", "description": "Admission to medicare care choice model program (mccm)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9481", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9482", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9483", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9484", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9486", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9487", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9488", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9489", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code", "description": "Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma", "description": "Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9496", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Received instruction from the anesthesiologist or proxy prior to the day of surgery to abstain from smoking on the day of surgery", "description": "Received instruction from the anesthesiologist or proxy prior to the day of surgery to abstain from smoking on the day of surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9497", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antibiotic regimen prescribed", "description": "Antibiotic regimen prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9498", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period", "description": "Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation exposure indices, or exposure time and number of fluorographic images in final report for procedures using fluoroscopy, documented", "description": "Radiation exposure indices, or exposure time and number of fluorographic images in final report for procedures using fluoroscopy, documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiation exposure indices, or exposure time and number of fluorographic images not documented in final report for procedure using fluoroscopy, reason not given", "description": "Radiation exposure indices, or exposure time and number of fluorographic images not documented in final report for procedure using fluoroscopy, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)", "description": "Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient taking tamsulosin hydrochloride", "description": "Patient taking tamsulosin hydrochloride", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy", "description": "Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason", "description": "Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Biologic immune response modifier prescribed", "description": "Biologic immune response modifier prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)", "description": "Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that the patient is not on a statin medication", "description": "Documentation that the patient is not on a statin medication", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5", "description": "Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5", "description": "Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period", "description": "Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9511", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Individual had a pdc of 0.8 or greater", "description": "Individual had a pdc of 0.8 or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Individual did not have a pdc of 0.8 or greater", "description": "Individual did not have a pdc of 0.8 or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient required a return to the operating room within 90 days of surgery", "description": "Patient required a return to the operating room within 90 days of surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9514", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not require a return to the operating room within 90 days of surgery", "description": "Patient did not require a return to the operating room within 90 days of surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery", "description": "Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9516", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given", "description": "Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9517", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of active injection drug use", "description": "Documentation of active injection drug use", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9518", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery", "description": "Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9519", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery", "description": "Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months", "description": "Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9521", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given", "description": "Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9522", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient discontinued from hemodialysis or peritoneal dialysis", "description": "Patient discontinued from hemodialysis or peritoneal dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9523", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was referred to hospice care", "description": "Patient was referred to hospice care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9524", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)", "description": "Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9525", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was not referred to hospice care, reason not given", "description": "Patient was not referred to hospice care, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9526", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with minor blunt head trauma had an appropriate indication(s) for a head ct", "description": "Patient with minor blunt head trauma had an appropriate indication(s) for a head ct", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9529", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider", "description": "Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar", "description": "Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9531", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma", "description": "Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9532", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct", "description": "Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9533", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Advanced brain imaging (cta, ct, mra or mri) was not ordered", "description": "Advanced brain imaging (cta, ct, mra or mri) was not ordered", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9534", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with a normal neurological examination", "description": "Patients with a normal neurological examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9535", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)", "description": "Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9536", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Imaging needed as part of a clinical trial; or other clinician ordered the study", "description": "Imaging needed as part of a clinical trial; or other clinician ordered the study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9537", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Advanced brain imaging (cta, ct, mra or mri) was ordered", "description": "Advanced brain imaging (cta, ct, mra or mri) was ordered", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9538", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intent for potential removal at time of placement", "description": "Intent for potential removal at time of placement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9539", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient alive 3 months post procedure", "description": "Patient alive 3 months post procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filter removed within 3 months of placement", "description": "Filter removed within 3 months of placement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9541", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented re-assessment for the appropriateness of filter removal within 3 months of placement", "description": "Documented re-assessment for the appropriateness of filter removal within 3 months of placement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9542", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement", "description": "Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9543", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement", "description": "Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9544", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols", "description": "Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9547", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final reports for imaging studies stating no follow-up imaging is recommended", "description": "Final reports for imaging studies stating no follow-up imaging is recommended", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9548", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))", "description": "Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9549", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final reports for imaging studies with follow-up imaging recommended, or final reports that do not include a specific recommendation of no follow-up", "description": "Final reports for imaging studies with follow-up imaging recommended, or final reports that do not include a specific recommendation of no follow-up", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final reports for imaging studies without an incidentally found lesion noted", "description": "Final reports for imaging studies without an incidentally found lesion noted", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9551", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incidental thyroid nodule < 1.0 cm noted in report", "description": "Incidental thyroid nodule < 1.0 cm noted in report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9552", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prior thyroid disease diagnosis", "description": "Prior thyroid disease diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9553", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging recommended", "description": "Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging recommended", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9554", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))", "description": "Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9555", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging not recommended", "description": "Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging not recommended", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9556", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final reports for ct, cta, mri or mra studies of the chest or neck or ultrasound of the neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule found", "description": "Final reports for ct, cta, mri or mra studies of the chest or neck or ultrasound of the neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule found", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9557", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient treated with a beta-lactam antibiotic as definitive therapy", "description": "Patient treated with a beta-lactam antibiotic as definitive therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9558", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)", "description": "Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9559", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given", "description": "Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients prescribed opiates for longer than six weeks", "description": "Patients prescribed opiates for longer than six weeks", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9561", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who had a follow-up evaluation conducted at least every three months during opioid therapy", "description": "Patients who had a follow-up evaluation conducted at least every three months during opioid therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy", "description": "Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9563", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Index date phq-score greater than 9 documented during the twelve month denominator identification period", "description": "Index date phq-score greater than 9 documented during the twelve month denominator identification period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9572", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five", "description": "Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9573", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five; either phq-9 or phq-9m score was not assessed or is greater than or equal to five", "description": "Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five; either phq-9 or phq-9m score was not assessed or is greater than or equal to five", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9574", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients prescribed opiates for longer than six weeks", "description": "Patients prescribed opiates for longer than six weeks", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9577", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of signed opioid treatment agreement at least once during opioid therapy", "description": "Documentation of signed opioid treatment agreement at least once during opioid therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9578", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation of signed an opioid treatment agreement at least once during opioid therapy", "description": "No documentation of signed an opioid treatment agreement at least once during opioid therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9579", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Door to puncture time of less than 2 hours", "description": "Door to puncture time of less than 2 hours", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Door to puncture time of greater than 2 hours for reasons documented by clinician (e.g., patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment; hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment)", "description": "Door to puncture time of greater than 2 hours for reasons documented by clinician (e.g., patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment; hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9581", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Door to puncture time of greater than 2 hours, no reason given", "description": "Door to puncture time of greater than 2 hours, no reason given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9582", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients prescribed opiates for longer than six weeks", "description": "Patients prescribed opiates for longer than six weeks", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9583", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy", "description": "Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9584", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient not interviewed at least once during opioid therapy", "description": "Patient not evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient not interviewed at least once during opioid therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9585", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules", "description": "Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9593", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider", "description": "Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9594", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has documentation of ventricular shunt, brain tumor, or coagulopathy", "description": "Patient has documentation of ventricular shunt, brain tumor, or coagulopathy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9595", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma", "description": "Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9596", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules", "description": "Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9597", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted ct or minor diameter on axial formatted ct", "description": "Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted ct or minor diameter on axial formatted ct", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9598", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted ct or minor diameter on axial formatted ct", "description": "Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted ct or minor diameter on axial formatted ct", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9599", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Symptomatic aaas that required urgent/emergent (non-elective) repair", "description": "Symptomatic aaas that required urgent/emergent (non-elective) repair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient discharge to home no later than post-operative day #7", "description": "Patient discharge to home no later than post-operative day #7", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9601", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not discharged to home by post-operative day #7", "description": "Patient not discharged to home by post-operative day #7", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9602", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient survey score improved from baseline following treatment", "description": "Patient survey score improved from baseline following treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9603", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient survey results not available", "description": "Patient survey results not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient survey score did not improve from baseline following treatment", "description": "Patient survey score did not improve from baseline following treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9605", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intraoperative cystoscopy performed to evaluate for lower tract injury", "description": "Intraoperative cystoscopy performed to evaluate for lower tract injury", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death", "description": "Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9607", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intraoperative cystoscopy not performed to evaluate for lower tract injury", "description": "Intraoperative cystoscopy not performed to evaluate for lower tract injury", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9608", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of an order for anti-platelet agents", "description": "Documentation of an order for anti-platelet agents", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9609", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) in the patient's record for not ordering anti-platelet agents", "description": "Documentation of medical reason(s) in the patient's record for not ordering anti-platelet agents", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Order for anti-platelet agents was not documented in the patient's record, reason not given", "description": "Order for anti-platelet agents was not documented in the patient's record, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9611", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Photodocumentation of two or more cecal landmarks to establish a complete examination", "description": "Photodocumentation of two or more cecal landmarks to establish a complete examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9612", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.)", "description": "Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9613", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Photodocumentation of less than two cecal landmarks (i.e., no cecal landmarks or only one cecal landmark) to establish a complete examination", "description": "Photodocumentation of less than two cecal landmarks (i.e., no cecal landmarks or only one cecal landmark) to establish a complete examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9614", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preoperative assessment documented", "description": "Preoperative assessment documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason(s) for not documenting a preoperative assessment (e.g., patient with a gynecologic or other pelvic malignancy noted at the time of surgery)", "description": "Documentation of reason(s) for not documenting a preoperative assessment (e.g., patient with a gynecologic or other pelvic malignancy noted at the time of surgery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9616", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preoperative assessment not documented, reason not given", "description": "Preoperative assessment not documented, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9617", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind", "description": "Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9618", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)", "description": "Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9619", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not screened for uterine malignancy, or those that have not had an ultrasound and/or endometrial sampling of any kind, reason not given", "description": "Patient not screened for uterine malignancy, or those that have not had an ultrasound and/or endometrial sampling of any kind, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling", "description": "Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9621", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method", "description": "Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons)", "description": "Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9623", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user, reason not given", "description": "Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient sustained bladder injury at the time of surgery or discovered subsequently up to 30 days post-surgery", "description": "Patient sustained bladder injury at the time of surgery or discovered subsequently up to 30 days post-surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented medical reason for not reporting bladder injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bladder injury)", "description": "Documented medical reason for not reporting bladder injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bladder injury)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not sustain bladder injury at the time of surgery nor discovered subsequently up to 30n days post-surgery", "description": "Patient did not sustain bladder injury at the time of surgery nor discovered subsequently up to 30n days post-surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient sustained bowel injury at the time of surgery or discovered subsequently up to 30 days post-surgery", "description": "Patient sustained bowel injury at the time of surgery or discovered subsequently up to 30 days post-surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented medical reasons for not reporting bowel injury (e.g., gynecologic or other pelvic malignancy documented, planned (e.g., not due to an unexpected bowel injury) resection and/or re-anastomosis of bowel, or patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bowel injury)", "description": "Documented medical reasons for not reporting bowel injury (e.g., gynecologic or other pelvic malignancy documented, planned (e.g., not due to an unexpected bowel injury) resection and/or re-anastomosis of bowel, or patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bowel injury)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not sustain a bowel injury at the time of surgery nor discovered subsequently up to 30 days post-surgery", "description": "Patient did not sustain a bowel injury at the time of surgery nor discovered subsequently up to 30 days post-surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery", "description": "Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented medical reasons for not reporting ureter injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during a urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of ureter injury)", "description": "Documented medical reasons for not reporting ureter injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during a urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of ureter injury)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not sustain ureter injury at the time of surgery nor discovered subsequently up to 30 days post-surgery", "description": "Patient did not sustain ureter injury at the time of surgery nor discovered subsequently up to 30 days post-surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9633", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved", "description": "Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9634", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Health-related quality of life not assessed with tool for documented reason(s) (e.g., patient has a cognitive or neuropsychiatric impairment that impairs his/her ability to complete the hrqol survey, patient has the inability to read and/or write in order to complete the hrqol questionnaire)", "description": "Health-related quality of life not assessed with tool for documented reason(s) (e.g., patient has a cognitive or neuropsychiatric impairment that impairs his/her ability to complete the hrqol survey, patient has the inability to read and/or write in order to complete the hrqol questionnaire)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Health-related quality of life not assessed with tool during at least two visits or quality of life score declined", "description": "Health-related quality of life not assessed with tool during at least two visits or quality of life score declined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)", "description": "Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)", "description": "Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Major amputation or open surgical bypass not required within 48 hours of the index endovascular lower extremity revascularization procedure", "description": "Major amputation or open surgical bypass not required within 48 hours of the index endovascular lower extremity revascularization procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9639", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of planned hybrid or staged procedure", "description": "Documentation of planned hybrid or staged procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure", "description": "Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Current smoker (e.g., cigarette, cigar, pipe, e-cigarette or marijuana)", "description": "Current smoker (e.g., cigarette, cigar, pipe, e-cigarette or marijuana)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elective surgery", "description": "Elective surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9643", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who abstained from smoking prior to anesthesia on the day of surgery or procedure", "description": "Patients who abstained from smoking prior to anesthesia on the day of surgery or procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9644", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who did not abstain from smoking prior to anesthesia on the day of surgery or procedure", "description": "Patients who did not abstain from smoking prior to anesthesia on the day of surgery or procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9645", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with 90 day mrs score of 0 to 2", "description": "Patients with 90 day mrs score of 0 to 2", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9646", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients in whom mrs score could not be obtained at 90 day follow-up", "description": "Patients in whom mrs score could not be obtained at 90 day follow-up", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9647", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with 90 day mrs score greater than 2", "description": "Patients with 90 day mrs score greater than 2", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9648", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psoriasis assessment tool documented meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi))", "description": "Psoriasis assessment tool documented meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9649", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that the patient declined therapy change or has documented contraindications (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi", "description": "Documentation that the patient declined therapy change or has documented contraindications (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psoriasis assessment tool documented not meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi)) or psoriasis assessment tool not documented", "description": "Psoriasis assessment tool documented not meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi)) or psoriasis assessment tool not documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9651", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has been treated with a systemic or biologic medication for psoriasis for at least six months", "description": "Patient has been treated with a systemic or biologic medication for psoriasis for at least six months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9652", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months", "description": "Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9653", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Monitored anesthesia care (mac)", "description": "Monitored anesthesia care (mac)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9654", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is used", "description": "A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is used", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9655", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient transferred directly from anesthetizing location to pacu or other non-icu location", "description": "Patient transferred directly from anesthetizing location to pacu or other non-icu location", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9656", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer of care during an anesthetic or to the intensive care unit", "description": "Transfer of care during an anesthetic or to the intensive care unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9657", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is not used", "description": "A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is not used", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9658", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits", "description": "Patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9659", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for a colonoscopy performed on a patient greater than or equal to 86 years of age (e.g., iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial history of adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits)", "description": "Documentation of medical reason(s) for a colonoscopy performed on a patient greater than or equal to 86 years of age (e.g., iron deficiency anemia, lower gastrointestinal bleeding, crohn's disease (i.e., regional enteritis), familial history of adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients greater than or equal to 86 years of age who received a colonoscopy for an assessment of signs/symptoms of gi tract illness, and/or because the patient meets high risk criteria, and/or to follow-up on previously diagnosed advanced lesions", "description": "Patients greater than or equal to 86 years of age who received a colonoscopy for an assessment of signs/symptoms of gi tract illness, and/or because the patient meets high risk criteria, and/or to follow-up on previously diagnosed advanced lesions", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9661", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Previously diagnosed or have an active diagnosis of clinical ascvd", "description": "Previously diagnosed or have an active diagnosis of clinical ascvd", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9662", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Any fasting or direct ldl-c laboratory test result >= 190 mg/dl", "description": "Any fasting or direct ldl-c laboratory test result >= 190 mg/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9663", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who are currently statin therapy users or received an order (prescription) for statin therapy", "description": "Patients who are currently statin therapy users or received an order (prescription) for statin therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9664", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy", "description": "Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9665", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient's highest fasting or direct ldl-c laboratory test result in the measurement period or two years prior to the beginning of the measurement period is 70-189 mg/dl", "description": "Patient's highest fasting or direct ldl-c laboratory test result in the measurement period or two years prior to the beginning of the measurement period is 70-189 mg/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9666", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)", "description": "Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9667", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the multiple chronic conditions measures group", "description": "I intend to report the multiple chronic conditions measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9669", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the diabetic retinopathy measures group", "description": "I intend to report the diabetic retinopathy measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9671", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9672", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "I intend to report the cardiovascular prevention measures group", "description": "I intend to report the cardiovascular prevention measures group", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9673", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical ascvd diagnosis", "description": "Patients with clinical ascvd diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9674", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl", "description": "Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9675", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70-189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period", "description": "Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70-189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9676", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient", "description": "All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9677", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreement", "description": "Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9678", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiary", "description": "This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9679", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary", "description": "This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiary", "description": "This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9681", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiary", "description": "This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9682", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Facility service(s) for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder. (may only be billed once per day per beneficiary). this service is for a demonstration project", "description": "Facility service(s) for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder. (may only be billed once per day per beneficiary). this service is for a demonstration project", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9683", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "This code is for the onsite acute care treatment of a nursing facility resident for a uti; may only be billed once per day per beneficiary", "description": "This code is for the onsite acute care treatment of a nursing facility resident for a uti; may only be billed once per day per beneficiary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9684", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a demonstration project", "description": "Physician service or other qualified health care professional for the evaluation and management of a beneficiary's acute change in condition in a nursing facility. this service is for a demonstration project", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9685", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing facility interdisciplinary care team", "description": "Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing facility interdisciplinary care team", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9686", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services provided to patient any time during the measurement period", "description": "Hospice services provided to patient any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9687", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients using hospice services any time during the measurement period", "description": "Patients using hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9688", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient admitted for performance of elective carotid intervention", "description": "Patient admitted for performance of elective carotid intervention", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9689", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving hospice services any time during the measurement period", "description": "Patient receiving hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9690", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had hospice services any time during the measurement period", "description": "Patient had hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9691", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services received by patient any time during the measurement period", "description": "Hospice services received by patient any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9692", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient use of hospice services any time during the measurement period", "description": "Patient use of hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9693", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services utilized by patient any time during the measurement period", "description": "Hospice services utilized by patient any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9694", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Long-acting inhaled bronchodilator prescribed", "description": "Long-acting inhaled bronchodilator prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9695", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator", "description": "Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9696", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator", "description": "Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9697", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator", "description": "Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9698", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified", "description": "Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established", "description": "Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9701", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9702", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date", "description": "Episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9703", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ajcc breast cancer stage i: t1 mic or t1a documented", "description": "Ajcc breast cancer stage i: t1 mic or t1a documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9704", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented", "description": "Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9705", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low (or very low) risk of recurrence, prostate cancer", "description": "Low (or very low) risk of recurrence, prostate cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9706", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received hospice services any time during the measurement period", "description": "Patient received hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9707", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy", "description": "Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9708", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services used by patient any time during the measurement period", "description": "Hospice services used by patient any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9709", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was provided hospice services any time during the measurement period", "description": "Patient was provided hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with a diagnosis or past history of total colectomy or colorectal cancer", "description": "Patients with a diagnosis or past history of total colectomy or colorectal cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9711", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis", "description": "Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9712", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9713", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is using hospice services any time during the measurement period", "description": "Patient is using hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9714", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9715", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented reason", "description": "Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented reason", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9716", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation stating the patient has had a diagnosis of depression or has had a diagnosis of bipolar disorder", "description": "Documentation stating the patient has had a diagnosis of depression or has had a diagnosis of bipolar disorder", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9717", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services for patient provided any time during the measurement period", "description": "Hospice services for patient provided any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9718", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair", "description": "Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9719", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services for patient occurred any time during the measurement period", "description": "Hospice services for patient occurred any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair", "description": "Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9721", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented history of renal failure or baseline serum creatinine >= 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher", "description": "Documented history of renal failure or baseline serum creatinine >= 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9722", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services for patient received any time during the measurement period", "description": "Hospice services for patient received any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9723", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who had documentation of use of anticoagulant medications overlapping the measurement year", "description": "Patients who had documentation of use of anticoagulant medications overlapping the measurement year", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9724", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9725", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate", "description": "Patient refused to participate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9726", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "description": "Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9727", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate", "description": "Patient refused to participate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9728", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "description": "Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9729", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate", "description": "Patient refused to participate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "description": "Patient unable to complete the lepf prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9731", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate", "description": "Patient refused to participate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9732", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient unable to complete the low back fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "description": "Patient unable to complete the low back fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9733", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate", "description": "Patient refused to participate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9734", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient unable to complete the shoulder fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "description": "Patient unable to complete the shoulder fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9735", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate", "description": "Patient refused to participate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9736", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient unable to complete the elbow/wrist/hand fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "description": "Patient unable to complete the elbow/wrist/hand fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9737", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient refused to participate", "description": "Patient refused to participate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9738", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient unable to complete the general orthopedic fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "description": "Patient unable to complete the general orthopedic fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9739", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services given to patient any time during the measurement period", "description": "Hospice services given to patient any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9741", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psychiatric symptoms assessed", "description": "Psychiatric symptoms assessed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9742", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psychiatric symptoms not assessed, reason not otherwise specified", "description": "Psychiatric symptoms not assessed, reason not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9743", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not eligible due to active diagnosis of hypertension", "description": "Patient not eligible due to active diagnosis of hypertension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9744", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documented reason for not screening or recommending a follow-up for high blood pressure", "description": "Documented reason for not screening or recommending a follow-up for high blood pressure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9745", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)", "description": "Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9746", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is undergoing palliative dialysis with a catheter", "description": "Patient is undergoing palliative dialysis with a catheter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9747", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant", "description": "Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9748", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is undergoing palliative dialysis with a catheter", "description": "Patient is undergoing palliative dialysis with a catheter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9749", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant", "description": "Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9750", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient died at any time during the 24-month measurement period", "description": "Patient died at any time during the 24-month measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9751", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency surgery", "description": "Emergency surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9752", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason for not conducting a search for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., trauma, acute myocardial infarction, stroke, aortic aneurysm where time is of the essence)", "description": "Documentation of medical reason for not conducting a search for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., trauma, acute myocardial infarction, stroke, aortic aneurysm where time is of the essence)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9753", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "A finding of an incidental pulmonary nodule", "description": "A finding of an incidental pulmonary nodule", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9754", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not including a recommended interval and modality for follow-up or for no follow-up, and source of recommendations (e.g., patients with unexplained fever, immunocompromised patients who are at risk for infection)", "description": "Documentation of medical reason(s) for not including a recommended interval and modality for follow-up or for no follow-up, and source of recommendations (e.g., patients with unexplained fever, immunocompromised patients who are at risk for infection)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9755", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical procedures that included the use of silicone oil", "description": "Surgical procedures that included the use of silicone oil", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9756", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical procedures that included the use of silicone oil", "description": "Surgical procedures that included the use of silicone oil", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9757", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient in hospice at any time during the measurement period", "description": "Patient in hospice at any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9758", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "History of preoperative posterior capsule rupture", "description": "History of preoperative posterior capsule rupture", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9759", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9761", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays", "description": "Patient had at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9762", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not have at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays", "description": "Patient did not have at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9763", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has been treated with a systemic medication for psoriasis vulgaris", "description": "Patient has been treated with a systemic medication for psoriasis vulgaris", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9764", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi", "description": "Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9765", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment", "description": "Patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9766", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment", "description": "Hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9767", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who utilize hospice services any time during the measurement period", "description": "Patients who utilize hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9768", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months", "description": "Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9769", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Peripheral nerve block (pnb)", "description": "Peripheral nerve block (pnb)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time", "description": "At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9771", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (e.g., emergency cases, intentional hypothermia, etc.)", "description": "Documentation of medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (e.g., emergency cases, intentional hypothermia, etc.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9772", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time, reason not given", "description": "At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9773", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who have had a hysterectomy", "description": "Patients who have had a hysterectomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9774", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively", "description": "Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9775", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)", "description": "Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9776", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively", "description": "Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9777", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who have a diagnosis of pregnancy", "description": "Patients who have a diagnosis of pregnancy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9778", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who are breastfeeding", "description": "Patients who are breastfeeding", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9779", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who have a diagnosis of rhabdomyolysis", "description": "Patients who have a diagnosis of rhabdomyolysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who are receiving palliative or hospice care, patients with active liver disease or hepatic disease or insufficiency, and patients with end stage renal disease (esrd))", "description": "Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who are receiving palliative or hospice care, patients with active liver disease or hepatic disease or insufficiency, and patients with end stage renal disease (esrd))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9781", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "History of or active diagnosis of familial or pure hypercholesterolemia", "description": "History of or active diagnosis of familial or pure hypercholesterolemia", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9782", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patients with diabetes who have a most recent fasting or direct ldl- c laboratory test result < 70 mg/dl and are not taking statin therapy", "description": "Documentation of patients with diabetes who have a most recent fasting or direct ldl- c laboratory test result < 70 mg/dl and are not taking statin therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9783", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathologists/dermatopathologists providing a second opinion on a biopsy", "description": "Pathologists/dermatopathologists providing a second opinion on a biopsy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9784", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist", "description": "Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9785", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) was not sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist", "description": "Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) was not sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9786", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient alive as of the last day of the measurement year", "description": "Patient alive as of the last day of the measurement year", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9787", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent bp is less than or equal to 140/90 mm hg", "description": "Most recent bp is less than or equal to 140/90 mm hg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9788", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood pressure recorded during inpatient stays, emergency room visits, urgent care visits, and patient self-reported bp's (home and health fair bp results)", "description": "Blood pressure recorded during inpatient stays, emergency room visits, urgent care visits, and patient self-reported bp's (home and health fair bp results)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9789", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent bp is greater than 140/90 mm hg, or blood pressure not documented", "description": "Most recent bp is greater than 140/90 mm hg, or blood pressure not documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9790", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent tobacco status is tobacco free", "description": "Most recent tobacco status is tobacco free", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9791", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most recent tobacco status is not tobacco free", "description": "Most recent tobacco status is not tobacco free", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9792", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is currently on a daily aspirin or other antiplatelet", "description": "Patient is currently on a daily aspirin or other antiplatelet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9793", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g., history of gastrointestinal bleed, intra-cranial bleed, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)", "description": "Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g., history of gastrointestinal bleed, intra-cranial bleed, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9794", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is not currently on a daily aspirin or other antiplatelet", "description": "Patient is not currently on a daily aspirin or other antiplatelet", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9795", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is currently on a statin therapy", "description": "Patient is currently on a statin therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9796", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient is not on a statin therapy", "description": "Patient is not on a statin therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9797", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Discharge(s) for ami between july 1 of the year prior measurement period to june 30 of the measurement period", "description": "Discharge(s) for ami between july 1 of the year prior measurement period to june 30 of the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9798", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with a medication dispensing event indicator of a history of asthma any time during the patient's history through the end of the measure period", "description": "Patients with a medication dispensing event indicator of a history of asthma any time during the patient's history through the end of the measure period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9799", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who are identified as having an intolerance or allergy to beta-blocker therapy", "description": "Patients who are identified as having an intolerance or allergy to beta-blocker therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis", "description": "Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9801", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9802", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami", "description": "Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9803", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami", "description": "Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9804", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9805", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who received cervical cytology or an hpv test", "description": "Patients who received cervical cytology or an hpv test", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9806", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who did not receive cervical cytology or an hpv test", "description": "Patients who did not receive cervical cytology or an hpv test", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9807", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Any patients who had no asthma controller medications dispensed during the measurement year", "description": "Any patients who had no asthma controller medications dispensed during the measurement year", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9808", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9809", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient achieved a pdc of at least 75% for their asthma controller medication", "description": "Patient achieved a pdc of at least 75% for their asthma controller medication", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not achieve a pdc of at least 75% for their asthma controller medication", "description": "Patient did not achieve a pdc of at least 75% for their asthma controller medication", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9811", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure", "description": "Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9812", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not die within 30 days of the procedure or during the index hospitalization", "description": "Patient did not die within 30 days of the procedure or during the index hospitalization", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9813", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Death occurring during the index acute care hospitalization", "description": "Death occurring during the index acute care hospitalization", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9814", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Death did not occur during the index acute care hospitalization", "description": "Death did not occur during the index acute care hospitalization", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9815", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Death occurring after discharge from the hospital but within 30 days post procedure", "description": "Death occurring after discharge from the hospital but within 30 days post procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9816", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Death did not occur after discharge from the hospital within 30 days post procedure", "description": "Death did not occur after discharge from the hospital within 30 days post procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9817", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of sexual activity", "description": "Documentation of sexual activity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9818", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who use hospice services any time during the measurement period", "description": "Patients who use hospice services any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9819", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of a chlamydia screening test with proper follow-up", "description": "Documentation of a chlamydia screening test with proper follow-up", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9820", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No documentation of a chlamydia screening test with proper follow-up", "description": "No documentation of a chlamydia screening test with proper follow-up", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9821", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)", "description": "Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9822", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Endometrial sampling or hysteroscopy with biopsy and results documented", "description": "Endometrial sampling or hysteroscopy with biopsy and results documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9823", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Endometrial sampling or hysteroscopy with biopsy and results not documented", "description": "Endometrial sampling or hysteroscopy with biopsy and results not documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9824", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Her-2/neu negative or undocumented/unknown", "description": "Her-2/neu negative or undocumented/unknown", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9825", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient transferred to practice after initiation of chemotherapy", "description": "Patient transferred to practice after initiation of chemotherapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9826", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Her2-targeted therapies not administered during the initial course of treatment", "description": "Her2-targeted therapies not administered during the initial course of treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9827", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Her2-targeted therapies administered during the initial course of treatment", "description": "Her2-targeted therapies administered during the initial course of treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9828", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast adjuvant chemotherapy administered", "description": "Breast adjuvant chemotherapy administered", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9829", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Her-2/neu positive", "description": "Her-2/neu positive", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ajcc stage at breast cancer diagnosis = ii or iii", "description": "Ajcc stage at breast cancer diagnosis = ii or iii", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9831", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis does not equal = t1, t1a, t1b", "description": "Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis does not equal = t1, t1a, t1b", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9832", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient transfer to practice after initiation of chemotherapy", "description": "Patient transfer to practice after initiation of chemotherapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9833", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has metastatic disease at diagnosis", "description": "Patient has metastatic disease at diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9834", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trastuzumab administered within 12 months of diagnosis", "description": "Trastuzumab administered within 12 months of diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9835", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)", "description": "Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9836", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trastuzumab not administered within 12 months of diagnosis", "description": "Trastuzumab not administered within 12 months of diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9837", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has metastatic disease at diagnosis", "description": "Patient has metastatic disease at diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9838", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anti-egfr monoclonal antibody therapy", "description": "Anti-egfr monoclonal antibody therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9839", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moab", "description": "Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moab", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moab", "description": "Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moab", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9841", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient has metastatic disease at diagnosis", "description": "Patient has metastatic disease at diagnosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9842", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ras (kras or nras) gene mutation", "description": "Ras (kras or nras) gene mutation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9843", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive anti-egfr monoclonal antibody therapy", "description": "Patient did not receive anti-egfr monoclonal antibody therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9844", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received anti-egfr monoclonal antibody therapy", "description": "Patient received anti-egfr monoclonal antibody therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9845", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who died from cancer", "description": "Patients who died from cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9846", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received chemotherapy in the last 14 days of life", "description": "Patient received chemotherapy in the last 14 days of life", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9847", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive chemotherapy in the last 14 days of life", "description": "Patient did not receive chemotherapy in the last 14 days of life", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9848", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who died from cancer", "description": "Patients who died from cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9849", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had more than one emergency department visit in the last 30 days of life", "description": "Patient had more than one emergency department visit in the last 30 days of life", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had one or less emergency department visits in the last 30 days of life", "description": "Patient had one or less emergency department visits in the last 30 days of life", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9851", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who died from cancer", "description": "Patients who died from cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9852", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient admitted to the icu in the last 30 days of life", "description": "Patient admitted to the icu in the last 30 days of life", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9853", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was not admitted to the icu in the last 30 days of life", "description": "Patient was not admitted to the icu in the last 30 days of life", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9854", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who died from cancer", "description": "Patients who died from cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9855", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was not admitted to hospice", "description": "Patient was not admitted to hospice", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9856", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient admitted to hospice", "description": "Patient admitted to hospice", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9857", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient enrolled in hospice", "description": "Patient enrolled in hospice", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9858", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who died from cancer", "description": "Patients who died from cancer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9859", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient spent less than three days in hospice care", "description": "Patient spent less than three days in hospice care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9860", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient spent greater than or equal to three days in hospice care", "description": "Patient spent greater than or equal to three days in hospice care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9861", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)", "description": "Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9862", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes", "description": "Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9868", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes", "description": "Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9869", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes", "description": "Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9870", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "First medicare diabetes prevention program (mdpp) core session was attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions", "description": "First medicare diabetes prevention program (mdpp) core session was attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9873", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Four total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions", "description": "Four total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9874", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nine total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions", "description": "Nine total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9875", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9", "description": "Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9876", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12", "description": "Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9877", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions.the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9", "description": "Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions.the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9878", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12", "description": "Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9879", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "The mdpp beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight in months 1-12 of the mdpp services period under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 5% weight loss from baseline as measured by an in-person weight measurement at a core session or core maintenance session", "description": "The mdpp beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight in months 1-12 of the mdpp services period under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 5% weight loss from baseline as measured by an in-person weight measurement at a core session or core maintenance session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9880", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session", "description": "The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9881", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 13-15 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 13-15", "description": "Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 13-15 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 13-15", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9882", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 16-18 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 16-18", "description": "Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 16-18 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 16-18", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9883", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 19-21 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 19-21", "description": "Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 19-21 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 19-21", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9884", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 22-24 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 22-24", "description": "Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 22-24 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 22-24", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9885", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bridge payment: a one-time payment for the first medicare diabetes prevention program (mdpp) core session, core maintenance session, or ongoing maintenance session furnished by an mdpp supplier to an mdpp beneficiary during months 1-24 of the mdpp expanded model (em) who has previously received mdpp services from a different mdpp supplier under the mdpp expanded model. a supplier may only receive one bridge payment per mdpp beneficiary", "description": "Bridge payment: a one-time payment for the first medicare diabetes prevention program (mdpp) core session, core maintenance session, or ongoing maintenance session furnished by an mdpp supplier to an mdpp beneficiary during months 1-24 of the mdpp expanded model (em) who has previously received mdpp services from a different mdpp supplier under the mdpp expanded model. a supplier may only receive one bridge payment per mdpp beneficiary", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the payable mdpp expanded model hcpcs code (this code is for reporting purposes only)", "description": "Mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the payable mdpp expanded model hcpcs code (this code is for reporting purposes only)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9891", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not performing a dilated macular examination", "description": "Documentation of patient reason(s) for not performing a dilated macular examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9892", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dilated macular exam was not performed, reason not otherwise specified", "description": "Dilated macular exam was not performed, reason not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9893", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate", "description": "Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9894", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g., salvage therapy)", "description": "Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g., salvage therapy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9895", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate", "description": "Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9896", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate, reason not given", "description": "Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9897", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period", "description": "Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9898", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed", "description": "Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9899", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified", "description": "Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period", "description": "Patient age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9901", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient screened for tobacco use and identified as a tobacco user", "description": "Patient screened for tobacco use and identified as a tobacco user", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9902", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient screened for tobacco use and identified as a tobacco non-user", "description": "Patient screened for tobacco use and identified as a tobacco non-user", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9903", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)", "description": "Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9904", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not screened for tobacco use, reason not given", "description": "Patient not screened for tobacco use, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9905", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)", "description": "Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9906", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g., limited life expectancy, other medical reason)", "description": "Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g., limited life expectancy, other medical reason)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9907", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy), reason not given", "description": "Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy), reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9908", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (eg, limited life expectancy, other medical reason)", "description": "Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (eg, limited life expectancy, other medical reason)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9909", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period", "description": "Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy", "description": "Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9911", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis b virus (hbv) status assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy", "description": "Hepatitis b virus (hbv) status assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9912", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hepatitis b virus (hbv) status not assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy, reason not given", "description": "Hepatitis b virus (hbv) status not assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9913", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient receiving an anti-tnf agent", "description": "Patient receiving an anti-tnf agent", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9914", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No record of hbv results documented", "description": "No record of hbv results documented", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9915", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status performed once in the last 12 months", "description": "Functional status performed once in the last 12 months", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9916", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of advanced stage dementia and caregiver knowledge is limited", "description": "Documentation of advanced stage dementia and caregiver knowledge is limited", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9917", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status not performed, reason not otherwise specified", "description": "Functional status not performed, reason not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9918", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening performed and positive and provision of recommendations", "description": "Screening performed and positive and provision of recommendations", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9919", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening performed and negative", "description": "Screening performed and negative", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9920", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specified", "description": "No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9921", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Safety concerns screen provided and if positive then documented mitigation recommendations", "description": "Safety concerns screen provided and if positive then documented mitigation recommendations", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9922", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Safety concerns screen provided and negative", "description": "Safety concerns screen provided and negative", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9923", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations, orders or referrals for positive screen (e.g., patient in palliative care, other medical reason)", "description": "Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations, orders or referrals for positive screen (e.g., patient in palliative care, other medical reason)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9924", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Safety concerns screening not provided, reason not otherwise specified", "description": "Safety concerns screening not provided, reason not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9925", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Safety concerns screening positive screen is without provision of mitigation recommendations, including but not limited to referral to other resources", "description": "Safety concerns screening positive screen is without provision of mitigation recommendations, including but not limited to referral to other resources", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9926", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of system reason(s) for not prescribing warfarin or another fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment", "description": "Documentation of system reason(s) for not prescribing warfarin or another fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9927", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Warfarin or another fda-approved anticoagulant not prescribed, reason not given", "description": "Warfarin or another fda-approved anticoagulant not prescribed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9928", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)", "description": "Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9929", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who are receiving comfort care only", "description": "Patients who are receiving comfort care only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of cha2ds2-vasc risk score of 0 or 1 for men; or 0, 1, or 2 for women", "description": "Documentation of cha2ds2-vasc risk score of 0 or 1 for men; or 0, 1, or 2 for women", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9931", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patient reason(s) for not having records of negative or managed positive tb screen (e.g., patient does not return for mantoux (ppd) skin test evaluation)", "description": "Documentation of patient reason(s) for not having records of negative or managed positive tb screen (e.g., patient does not return for mantoux (ppd) skin test evaluation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9932", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adenoma(s) or colorectal cancer detected during screening colonoscopy", "description": "Adenoma(s) or colorectal cancer detected during screening colonoscopy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9933", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma", "description": "Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9934", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adenoma(s) or colorectal cancer not detected during screening colonoscopy", "description": "Adenoma(s) or colorectal cancer not detected during screening colonoscopy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9935", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus", "description": "Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9936", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diagnostic colonoscopy", "description": "Diagnostic colonoscopy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9937", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the six months prior to the measurement period through december 31 of the measurement period", "description": "Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the six months prior to the measurement period through december 31 of the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9938", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathologists/dermatopathologists is the same clinician who performed the biopsy", "description": "Pathologists/dermatopathologists is the same clinician who performed the biopsy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9939", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitro fertilization, clomiphene rx, esrd, cirrhosis, muscular pain and disease during the measurement period or prior year)", "description": "Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitro fertilization, clomiphene rx, esrd, cirrhosis, muscular pain and disease during the measurement period or prior year)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively", "description": "Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9941", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy", "description": "Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9942", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at three months ( 6 - 20 weeks) postoperatively", "description": "Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at three months ( 6 - 20 weeks) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9943", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively", "description": "Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9944", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis", "description": "Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9945", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively", "description": "Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9946", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively", "description": "Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9947", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy", "description": "Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9948", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg pain was not measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively", "description": "Leg pain was not measured by the visual analog scale (vas) at three months (6 - 20 weeks) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9949", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient exhibits 2 or more risk factors for post-operative vomiting", "description": "Patient exhibits 2 or more risk factors for post-operative vomiting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9954", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cases in which an inhalational anesthetic is used only for induction", "description": "Cases in which an inhalational anesthetic is used only for induction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9955", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively", "description": "Patient received combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9956", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)", "description": "Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9957", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively", "description": "Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9958", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Systemic antimicrobials not prescribed", "description": "Systemic antimicrobials not prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9959", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for prescribing systemic antimicrobials", "description": "Documentation of medical reason(s) for prescribing systemic antimicrobials", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Systemic antimicrobials prescribed", "description": "Systemic antimicrobials prescribed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9961", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery anatomy", "description": "Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery anatomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9962", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine artery anatomy", "description": "Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine artery anatomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9963", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient received at least one well-child visit with a pcp during the performance period", "description": "Patient received at least one well-child visit with a pcp during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9964", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient did not receive at least one well-child visit with a pcp during the performance period", "description": "Patient did not receive at least one well-child visit with a pcp during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9965", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report", "description": "Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9966", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report", "description": "Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9967", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was referred to another provider or specialist during the performance period", "description": "Patient was referred to another provider or specialist during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9968", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Provider who referred the patient to another provider received a report from the provider to whom the patient was referred", "description": "Provider who referred the patient to another provider received a report from the provider to whom the patient was referred", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9969", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred", "description": "Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity", "description": "Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9974", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason(s) for not performing a dilated macular examination", "description": "Documentation of medical reason(s) for not performing a dilated macular examination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9975", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9978", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9979", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9981", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9983", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9984", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9985", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "description": "Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9986", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a bpci advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code", "description": "Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a bpci advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G9987", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug assessment", "description": "Alcohol and/or drug assessment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health screening to determine eligibility for admission to treatment program", "description": "Behavioral health screening to determine eligibility for admission to treatment program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs", "description": "Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health counseling and therapy, per 15 minutes", "description": "Behavioral health counseling and therapy, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; group counseling by a clinician", "description": "Alcohol and/or drug services; group counseling by a clinician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; case management", "description": "Alcohol and/or drug services; case management", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; crisis intervention (outpatient)", "description": "Alcohol and/or drug services; crisis intervention (outpatient)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; sub-acute detoxification (hospital inpatient)", "description": "Alcohol and/or drug services; sub-acute detoxification (hospital inpatient)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; acute detoxification (hospital inpatient)", "description": "Alcohol and/or drug services; acute detoxification (hospital inpatient)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)", "description": "Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)", "description": "Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient)", "description": "Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; acute detoxification (residential addiction program outpatient)", "description": "Alcohol and/or drug services; acute detoxification (residential addiction program outpatient)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; ambulatory detoxification", "description": "Alcohol and/or drug services; ambulatory detoxification", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education", "description": "Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)", "description": "Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health; residential (hospital residential treatment program), without room and board, per diem", "description": "Behavioral health; residential (hospital residential treatment program), without room and board, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem", "description": "Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem", "description": "Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)", "description": "Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug training service (for staff and personnel not employed by providers)", "description": "Alcohol and/or drug training service (for staff and personnel not employed by providers)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug intervention service (planned facilitation)", "description": "Alcohol and/or drug intervention service (planned facilitation)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health outreach service (planned approach to reach a targeted population)", "description": "Behavioral health outreach service (planned approach to reach a targeted population)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude)", "description": "Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)", "description": "Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug prevention process service, community-based (delivery of services to develop skills of impactors)", "description": "Alcohol and/or drug prevention process service, community-based (delivery of services to develop skills of impactors)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug prevention environmental service (broad range of external activities geared toward modifying systems in order to mainstream prevention through policy and law)", "description": "Alcohol and/or drug prevention environmental service (broad range of external activities geared toward modifying systems in order to mainstream prevention through policy and law)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug prevention problem identification and referral service (e.g., student assistance and employee assistance programs), does not include assessment", "description": "Alcohol and/or drug prevention problem identification and referral service (e.g., student assistance and employee assistance programs), does not include assessment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug prevention alternatives service (services for populations that exclude alcohol and other drug use e.g., alcohol free social events)", "description": "Alcohol and/or drug prevention alternatives service (services for populations that exclude alcohol and other drug use e.g., alcohol free social events)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health hotline service", "description": "Behavioral health hotline service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mental health assessment, by non-physician", "description": "Mental health assessment, by non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mental health service plan development by non-physician", "description": "Mental health service plan development by non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral medication administration, direct observation", "description": "Oral medication administration, direct observation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication training and support, per 15 minutes", "description": "Medication training and support, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mental health partial hospitalization, treatment, less than 24 hours", "description": "Mental health partial hospitalization, treatment, less than 24 hours", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Community psychiatric supportive treatment, face-to-face, per 15 minutes", "description": "Community psychiatric supportive treatment, face-to-face, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Community psychiatric supportive treatment program, per diem", "description": "Community psychiatric supportive treatment program, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Self-help/peer services, per 15 minutes", "description": "Self-help/peer services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assertive community treatment, face-to-face, per 15 minutes", "description": "Assertive community treatment, face-to-face, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assertive community treatment program, per diem", "description": "Assertive community treatment program, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foster care, child, non-therapeutic, per diem", "description": "Foster care, child, non-therapeutic, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foster care, child, non-therapeutic, per month", "description": "Foster care, child, non-therapeutic, per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supported housing, per diem", "description": "Supported housing, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supported housing, per month", "description": "Supported housing, per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Respite care services, not in the home, per diem", "description": "Respite care services, not in the home, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mental health services, not otherwise specified", "description": "Mental health services, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or other drug abuse services, not otherwise specified", "description": "Alcohol and/or other drug abuse services, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or other drug testing: collection and handling only, specimens other than blood", "description": "Alcohol and/or other drug testing: collection and handling only, specimens other than blood", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0048", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug screening", "description": "Alcohol and/or drug screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0049", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug services, brief intervention, per 15 minutes", "description": "Alcohol and/or drug services, brief intervention, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prenatal care, at-risk assessment", "description": "Prenatal care, at-risk assessment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H1000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prenatal care, at-risk enhanced service; antepartum management", "description": "Prenatal care, at-risk enhanced service; antepartum management", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H1001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prenatal care, at risk enhanced service; care coordination", "description": "Prenatal care, at risk enhanced service; care coordination", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H1002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prenatal care, at-risk enhanced service; education", "description": "Prenatal care, at-risk enhanced service; education", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H1003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prenatal care, at-risk enhanced service; follow-up home visit", "description": "Prenatal care, at-risk enhanced service; follow-up home visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H1004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prenatal care, at-risk enhanced service package (includes h1001-h1004)", "description": "Prenatal care, at-risk enhanced service package (includes h1001-h1004)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H1005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-medical family planning education, per session", "description": "Non-medical family planning education, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H1010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Family assessment by licensed behavioral health professional for state defined purposes", "description": "Family assessment by licensed behavioral health professional for state defined purposes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H1011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive multidisciplinary evaluation", "description": "Comprehensive multidisciplinary evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rehabilitation program, per 1/2 day", "description": "Rehabilitation program, per 1/2 day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive medication services, per 15 minutes", "description": "Comprehensive medication services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crisis intervention service, per 15 minutes", "description": "Crisis intervention service, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health day treatment, per hour", "description": "Behavioral health day treatment, per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psychiatric health facility service, per diem", "description": "Psychiatric health facility service, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skills training and development, per 15 minutes", "description": "Skills training and development, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive community support services, per 15 minutes", "description": "Comprehensive community support services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive community support services, per diem", "description": "Comprehensive community support services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psychosocial rehabilitation services, per 15 minutes", "description": "Psychosocial rehabilitation services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psychosocial rehabilitation services, per diem", "description": "Psychosocial rehabilitation services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic behavioral services, per 15 minutes", "description": "Therapeutic behavioral services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic behavioral services, per diem", "description": "Therapeutic behavioral services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Community-based wrap-around services, per 15 minutes", "description": "Community-based wrap-around services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Community-based wrap-around services, per diem", "description": "Community-based wrap-around services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supported employment, per 15 minutes", "description": "Supported employment, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supported employment, per diem", "description": "Supported employment, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing support to maintain employment, per 15 minutes", "description": "Ongoing support to maintain employment, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing support to maintain employment, per diem", "description": "Ongoing support to maintain employment, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Psychoeducational service, per 15 minutes", "description": "Psychoeducational service, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sexual offender treatment service, per 15 minutes", "description": "Sexual offender treatment service, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sexual offender treatment service, per diem", "description": "Sexual offender treatment service, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mental health clubhouse services, per 15 minutes", "description": "Mental health clubhouse services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mental health clubhouse services, per diem", "description": "Mental health clubhouse services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Activity therapy, per 15 minutes", "description": "Activity therapy, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Multisystemic therapy for juveniles, per 15 minutes", "description": "Multisystemic therapy for juveniles, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or drug abuse halfway house services, per diem", "description": "Alcohol and/or drug abuse halfway house services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or other drug treatment program, per hour", "description": "Alcohol and/or other drug treatment program, per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or other drug treatment program, per diem", "description": "Alcohol and/or other drug treatment program, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Developmental delay prevention activities, dependent child of client, per 15 minutes", "description": "Developmental delay prevention activities, dependent child of client, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tetracycline, up to 250 mg", "description": "Injection, tetracycline, up to 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, omadacycline, 1 mg", "description": "Injection, omadacycline, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, eravacycline, 1 mg", "description": "Injection, eravacycline, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "description": "Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0129", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection abciximab, 10 mg", "description": "Injection abciximab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, acetaminophen, 10 mg", "description": "Injection, acetaminophen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, acetylcysteine, 100 mg", "description": "Injection, acetylcysteine, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0132", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, acyclovir, 5 mg", "description": "Injection, acyclovir, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0133", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, adalimumab, 20 mg", "description": "Injection, adalimumab, 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0135", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)", "description": "Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, adenosine for diagnostic use, 1 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)", "description": "Injection, adenosine for diagnostic use, 1 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0151", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)", "description": "Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, adrenalin, epinephrine, 0.1 mg", "description": "Injection, adrenalin, epinephrine, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aflibercept, 1 mg", "description": "Injection, aflibercept, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0178", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, brolucizumab-dbll, 1 mg", "description": "Injection, brolucizumab-dbll, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0179", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, agalsidase beta, 1 mg", "description": "Injection, agalsidase beta, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aprepitant, 1 mg", "description": "Injection, aprepitant, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, biperiden lactate, per 5 mg", "description": "Injection, biperiden lactate, per 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alatrofloxacin mesylate, 100 mg", "description": "Injection, alatrofloxacin mesylate, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alemtuzumab, 1 mg", "description": "Injection, alemtuzumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alglucerase, per 10 units", "description": "Injection, alglucerase, per 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amifostine, 500 mg", "description": "Injection, amifostine, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methyldopate hcl, up to 250 mg", "description": "Injection, methyldopate hcl, up to 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alefacept, 0.5 mg", "description": "Injection, alefacept, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alglucosidase alfa, 10 mg, not otherwise specified", "description": "Injection, alglucosidase alfa, 10 mg, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alglucosidase alfa, (lumizyme), 10 mg", "description": "Injection, alglucosidase alfa, (lumizyme), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, patisiran, 0.1 mg", "description": "Injection, patisiran, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, givosiran, 0.5 mg", "description": "Injection, givosiran, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0223", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lumasiran, 0.5 mg", "description": "Injection, lumasiran, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0224", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg", "description": "Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0256", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg", "description": "Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "description": "Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "description": "Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amikacin sulfate, 100 mg", "description": "Injection, amikacin sulfate, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0278", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aminophyllin, up to 250 mg", "description": "Injection, aminophyllin, up to 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amiodarone hydrochloride, 30 mg", "description": "Injection, amiodarone hydrochloride, 30 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0282", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amphotericin b, 50 mg", "description": "Injection, amphotericin b, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amphotericin b lipid complex, 10 mg", "description": "Injection, amphotericin b lipid complex, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0287", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amphotericin b cholesteryl sulfate complex, 10 mg", "description": "Injection, amphotericin b cholesteryl sulfate complex, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0288", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amphotericin b liposome, 10 mg", "description": "Injection, amphotericin b liposome, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0289", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ampicillin sodium, 500 mg", "description": "Injection, ampicillin sodium, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, plazomicin, 5 mg", "description": "Injection, plazomicin, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0291", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm", "description": "Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0295", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amobarbital, up to 125 mg", "description": "Injection, amobarbital, up to 125 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, succinylcholine chloride, up to 20 mg", "description": "Injection, succinylcholine chloride, up to 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, anidulafungin, 1 mg", "description": "Injection, anidulafungin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0348", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, anistreplase, per 30 units", "description": "Injection, anistreplase, per 30 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydralazine hcl, up to 20 mg", "description": "Injection, hydralazine hcl, up to 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, apomorphine hydrochloride, 1 mg", "description": "Injection, apomorphine hydrochloride, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aprotonin, 10,000 kiu", "description": "Injection, aprotonin, 10,000 kiu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0365", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, metaraminol bitartrate, per 10 mg", "description": "Injection, metaraminol bitartrate, per 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, chloroquine hydrochloride, up to 250 mg", "description": "Injection, chloroquine hydrochloride, up to 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, arbutamine hcl, 1 mg", "description": "Injection, arbutamine hcl, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0395", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aripiprazole, intramuscular, 0.25 mg", "description": "Injection, aripiprazole, intramuscular, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aripiprazole, extended release, 1 mg", "description": "Injection, aripiprazole, extended release, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0401", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, azithromycin, 500 mg", "description": "Injection, azithromycin, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0456", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, atropine sulfate, 0.01 mg", "description": "Injection, atropine sulfate, 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0461", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dimercaprol, per 100 mg", "description": "Injection, dimercaprol, per 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, baclofen, 10 mg", "description": "Injection, baclofen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0475", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, baclofen, 50 mcg for intrathecal trial", "description": "Injection, baclofen, 50 mcg for intrathecal trial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0476", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, basiliximab, 20 mg", "description": "Injection, basiliximab, 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, belatacept, 1 mg", "description": "Injection, belatacept, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, belimumab, 10 mg", "description": "Injection, belimumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dicyclomine hcl, up to 20 mg", "description": "Injection, dicyclomine hcl, up to 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, benztropine mesylate, per 1 mg", "description": "Injection, benztropine mesylate, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, benralizumab, 1 mg", "description": "Injection, benralizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0517", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg", "description": "Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, penicillin g benzathine and penicillin g procaine, 100,000 units", "description": "Injection, penicillin g benzathine and penicillin g procaine, 100,000 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0558", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, penicillin g benzathine, 100,000 units", "description": "Injection, penicillin g benzathine, 100,000 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0561", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bezlotoxumab, 10 mg", "description": "Injection, bezlotoxumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0565", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cerliponase alfa, 1 mg", "description": "Injection, cerliponase alfa, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0567", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Buprenorphine implant, 74.2 mg", "description": "Buprenorphine implant, 74.2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Buprenorphine, oral, 1 mg", "description": "Buprenorphine, oral, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0571", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine", "description": "Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0572", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine", "description": "Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0573", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine", "description": "Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0574", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine", "description": "Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0575", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bivalirudin, 1 mg", "description": "Injection, bivalirudin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0583", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, burosumab-twza 1 mg", "description": "Injection, burosumab-twza 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0584", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, onabotulinumtoxina, 1 unit", "description": "Injection, onabotulinumtoxina, 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0585", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, abobotulinumtoxina, 5 units", "description": "Injection, abobotulinumtoxina, 5 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0586", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rimabotulinumtoxinb, 100 units", "description": "Injection, rimabotulinumtoxinb, 100 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0587", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, incobotulinumtoxin a, 1 unit", "description": "Injection, incobotulinumtoxin a, 1 unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0588", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, deoxycholic acid, 1 mg", "description": "Injection, deoxycholic acid, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0591", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, buprenorphine hydrochloride, 0.1 mg", "description": "Injection, buprenorphine hydrochloride, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0592", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lanadelumab-flyo, 1 mg (code may be used for medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)", "description": "Injection, lanadelumab-flyo, 1 mg (code may be used for medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0593", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "injection, busulfan, 1 mg", "description": "injection, busulfan, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0594", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, butorphanol tartrate, 1 mg", "description": "Injection, butorphanol tartrate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0595", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units", "description": "Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0596", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, c-1 esterase inhibitor (human), berinert, 10 units", "description": "Injection, c-1 esterase inhibitor (human), berinert, 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0597", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, c-1 esterase inhibitor (human), cinryze, 10 units", "description": "Injection, c-1 esterase inhibitor (human), cinryze, 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0598", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, c-1 esterase inhibitor (human), (haegarda), 10 units", "description": "Injection, c-1 esterase inhibitor (human), (haegarda), 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0599", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, edetate calcium disodium, up to 1000 mg", "description": "Injection, edetate calcium disodium, up to 1000 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cinacalcet, oral, 1 mg, (for esrd on dialysis)", "description": "Cinacalcet, oral, 1 mg, (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, etelcalcetide, 0.1 mg", "description": "Injection, etelcalcetide, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, calcium gluconate, per 10 ml", "description": "Injection, calcium gluconate, per 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, calcium glycerophosphate and calcium lactate, per 10 ml", "description": "Injection, calcium glycerophosphate and calcium lactate, per 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, calcitonin salmon, up to 400 units", "description": "Injection, calcitonin salmon, up to 400 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, calcitriol, 0.1 mcg", "description": "Injection, calcitriol, 0.1 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, caspofungin acetate, 5 mg", "description": "Injection, caspofungin acetate, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, canakinumab, 1 mg", "description": "Injection, canakinumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, leucovorin calcium, per 50 mg", "description": "Injection, leucovorin calcium, per 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, levoleucovorin, not otherwise specified, 0.5 mg", "description": "Injection, levoleucovorin, not otherwise specified, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, levoleucovorin (khapzory), 0.5 mg", "description": "Injection, levoleucovorin (khapzory), 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mepivacaine hydrochloride, per 10 ml", "description": "Injection, mepivacaine hydrochloride, per 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cefazolin sodium, 500 mg", "description": "Injection, cefazolin sodium, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0690", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lefamulin, 1 mg", "description": "Injection, lefamulin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0691", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cefepime hydrochloride, 500 mg", "description": "Injection, cefepime hydrochloride, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0692", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cefiderocol, 5 mg", "description": "Injection, cefiderocol, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0693", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cefoxitin sodium, 1 gm", "description": "Injection, cefoxitin sodium, 1 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0694", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ceftolozane 50 mg and tazobactam 25 mg", "description": "Injection, ceftolozane 50 mg and tazobactam 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0695", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ceftriaxone sodium, per 250 mg", "description": "Injection, ceftriaxone sodium, per 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0696", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sterile cefuroxime sodium, per 750 mg", "description": "Injection, sterile cefuroxime sodium, per 750 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0697", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cefotaxime sodium, per gm", "description": "Injection, cefotaxime sodium, per gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0698", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cefiderocol, 10 mg", "description": "Injection, cefiderocol, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg", "description": "Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0702", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, caffeine citrate, 5 mg", "description": "Injection, caffeine citrate, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0706", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cephapirin sodium, up to 1 gm", "description": "Injection, cephapirin sodium, up to 1 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ceftaroline fosamil, 10 mg", "description": "Injection, ceftaroline fosamil, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0712", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ceftazidime, per 500 mg", "description": "Injection, ceftazidime, per 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0713", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ceftazidime and avibactam, 0.5 g/0.125 g", "description": "Injection, ceftazidime and avibactam, 0.5 g/0.125 g", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0714", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ceftizoxime sodium, per 500 mg", "description": "Injection, ceftizoxime sodium, per 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0715", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, centruroides immune f(ab)2, up to 120 milligrams", "description": "Injection, centruroides immune f(ab)2, up to 120 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0716", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "description": "Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0717", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, chloramphenicol sodium succinate, up to 1 gm", "description": "Injection, chloramphenicol sodium succinate, up to 1 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, chorionic gonadotropin, per 1,000 usp units", "description": "Injection, chorionic gonadotropin, per 1,000 usp units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0725", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, clonidine hydrochloride, 1 mg", "description": "Injection, clonidine hydrochloride, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0735", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cidofovir, 375 mg", "description": "Injection, cidofovir, 375 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cabotegravir and rilpivirine, 2mg/3mg", "description": "Injection, cabotegravir and rilpivirine, 2mg/3mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0741", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg", "description": "Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0742", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cilastatin sodium; imipenem, per 250 mg", "description": "Injection, cilastatin sodium; imipenem, per 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0743", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ciprofloxacin for intravenous infusion, 200 mg", "description": "Injection, ciprofloxacin for intravenous infusion, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0744", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, codeine phosphate, per 30 mg", "description": "Injection, codeine phosphate, per 30 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0745", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, colchicine, per 1 mg", "description": "Injection, colchicine, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, colistimethate sodium, up to 150 mg", "description": "Injection, colistimethate sodium, up to 150 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, collagenase, clostridium histolyticum, 0.01 mg", "description": "Injection, collagenase, clostridium histolyticum, 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0775", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, prochlorperazine, up to 10 mg", "description": "Injection, prochlorperazine, up to 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, crizanlizumab-tmca, 5 mg", "description": "Injection, crizanlizumab-tmca, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0791", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, corticorelin ovine triflutate, 1 microgram", "description": "Injection, corticorelin ovine triflutate, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0795", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, corticotropin, up to 40 units", "description": "Injection, corticotropin, up to 40 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cosyntropin, not otherwise specified, 0.25 mg", "description": "Injection, cosyntropin, not otherwise specified, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0833", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cosyntropin, 0.25 mg", "description": "Injection, cosyntropin, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0834", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram", "description": "Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, crotalidae immune f(ab')2 (equine), 120 mg", "description": "Injection, crotalidae immune f(ab')2 (equine), 120 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0841", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cytomegalovirus immune globulin intravenous (human), per vial", "description": "Injection, cytomegalovirus immune globulin intravenous (human), per vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dalbavancin, 5 mg", "description": "Injection, dalbavancin, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0875", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, daptomycin, 1 mg", "description": "Injection, daptomycin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0878", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, darbepoetin alfa, 1 microgram (non-esrd use)", "description": "Injection, darbepoetin alfa, 1 microgram (non-esrd use)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0881", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)", "description": "Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0882", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, argatroban, 1 mg (for non-esrd use)", "description": "Injection, argatroban, 1 mg (for non-esrd use)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0883", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, argatroban, 1 mg (for esrd on dialysis)", "description": "Injection, argatroban, 1 mg (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0884", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin alfa, (for non-esrd use), 1000 units", "description": "Injection, epoetin alfa, (for non-esrd use), 1000 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0885", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin alfa, 1000 units (for esrd on dialysis)", "description": "Injection, epoetin alfa, 1000 units (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0886", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin beta, 1 microgram, (for esrd on dialysis)", "description": "Injection, epoetin beta, 1 microgram, (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0887", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin beta, 1 microgram, (for non esrd use)", "description": "Injection, epoetin beta, 1 microgram, (for non esrd use)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0888", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, peginesatide, 0.1 mg (for esrd on dialysis)", "description": "Injection, peginesatide, 0.1 mg (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, decitabine, 1 mg", "description": "Injection, decitabine, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0894", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, deferoxamine mesylate, 500 mg", "description": "Injection, deferoxamine mesylate, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0895", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, luspatercept-aamt, 0.25 mg", "description": "Injection, luspatercept-aamt, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0896", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, denosumab, 1 mg", "description": "Injection, denosumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0897", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone enanthate and estradiol valerate, up to 1 cc", "description": "Injection, testosterone enanthate and estradiol valerate, up to 1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, brompheniramine maleate, per 10 mg", "description": "Injection, brompheniramine maleate, per 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0945", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, depo-estradiol cypionate, up to 5 mg", "description": "Injection, depo-estradiol cypionate, up to 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methylprednisolone acetate, 20 mg", "description": "Injection, methylprednisolone acetate, 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methylprednisolone acetate, 40 mg", "description": "Injection, methylprednisolone acetate, 40 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methylprednisolone acetate, 80 mg", "description": "Injection, methylprednisolone acetate, 80 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, medroxyprogesterone acetate, 1 mg", "description": "Injection, medroxyprogesterone acetate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone cypionate and estradiol cypionate, up to 1 ml", "description": "Injection, testosterone cypionate and estradiol cypionate, up to 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone cypionate, up to 100 mg", "description": "Injection, testosterone cypionate, up to 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone cypionate, 1 mg", "description": "Injection, testosterone cypionate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1071", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone cypionate, 1 cc, 200 mg", "description": "Injection, testosterone cypionate, 1 cc, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dexamethasone acetate, 1 mg", "description": "Injection, dexamethasone acetate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1094", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dexamethasone 9 percent, intraocular, 1 microgram", "description": "Injection, dexamethasone 9 percent, intraocular, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1095", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dexamethasone, lacrimal ophthalmic insert, 0.1 mg", "description": "Dexamethasone, lacrimal ophthalmic insert, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1096", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml", "description": "Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1097", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dexamethasone sodium phosphate, 1 mg", "description": "Injection, dexamethasone sodium phosphate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dihydroergotamine mesylate, per 1 mg", "description": "Injection, dihydroergotamine mesylate, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, acetazolamide sodium, up to 500 mg", "description": "Injection, acetazolamide sodium, up to 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, diclofenac sodium, 0.5 mg", "description": "Injection, diclofenac sodium, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, digoxin, up to 0.5 mg", "description": "Injection, digoxin, up to 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, digoxin immune fab (ovine), per vial", "description": "Injection, digoxin immune fab (ovine), per vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, phenytoin sodium, per 50 mg", "description": "Injection, phenytoin sodium, per 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1165", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydromorphone, up to 4 mg", "description": "Injection, hydromorphone, up to 4 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dyphylline, up to 500 mg", "description": "Injection, dyphylline, up to 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dexrazoxane hydrochloride, per 250 mg", "description": "Injection, dexrazoxane hydrochloride, per 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, diphenhydramine hcl, up to 50 mg", "description": "Injection, diphenhydramine hcl, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cetirizine hydrochloride, 0.5 mg", "description": "Injection, cetirizine hydrochloride, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, chlorothiazide sodium, per 500 mg", "description": "Injection, chlorothiazide sodium, per 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dmso, dimethyl sulfoxide, 50%, 50 ml", "description": "Injection, dmso, dimethyl sulfoxide, 50%, 50 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methadone hcl, up to 10 mg", "description": "Injection, methadone hcl, up to 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dimenhydrinate, up to 50 mg", "description": "Injection, dimenhydrinate, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dipyridamole, per 10 mg", "description": "Injection, dipyridamole, per 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dobutamine hydrochloride, per 250 mg", "description": "Injection, dobutamine hydrochloride, per 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dolasetron mesylate, 10 mg", "description": "Injection, dolasetron mesylate, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dopamine hcl, 40 mg", "description": "Injection, dopamine hcl, 40 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, doripenem, 10 mg", "description": "Injection, doripenem, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1267", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, doxercalciferol, 1 mcg", "description": "Injection, doxercalciferol, 1 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ecallantide, 1 mg", "description": "Injection, ecallantide, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, eculizumab, 10 mg", "description": "Injection, eculizumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, edaravone, 1 mg", "description": "Injection, edaravone, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ravulizumab-cwvz, 10 mg", "description": "Injection, ravulizumab-cwvz, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1303", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, evinacumab-dgnb, 5mg", "description": "Injection, evinacumab-dgnb, 5mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1305", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, amitriptyline hcl, up to 20 mg", "description": "Injection, amitriptyline hcl, up to 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, elosulfase alfa, 1 mg", "description": "Injection, elosulfase alfa, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1322", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, enfuvirtide, 1 mg", "description": "Injection, enfuvirtide, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1324", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoprostenol, 0.5 mg", "description": "Injection, epoprostenol, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, eptifibatide, 5 mg", "description": "Injection, eptifibatide, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1327", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ergonovine maleate, up to 0.2 mg", "description": "Injection, ergonovine maleate, up to 0.2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ertapenem sodium, 500 mg", "description": "Injection, ertapenem sodium, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1335", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, erythromycin lactobionate, per 500 mg", "description": "Injection, erythromycin lactobionate, per 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, estradiol valerate, up to 10 mg", "description": "Injection, estradiol valerate, up to 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, estrogen conjugated, per 25 mg", "description": "Injection, estrogen conjugated, per 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, casimersen, 10 mg", "description": "Injection, casimersen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1426", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, viltolarsen, 10 mg", "description": "Injection, viltolarsen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1427", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, eteplirsen, 10 mg", "description": "Injection, eteplirsen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1428", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, golodirsen, 10 mg", "description": "Injection, golodirsen, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1429", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ethanolamine oleate, 100 mg", "description": "Injection, ethanolamine oleate, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, estrone, per 1 mg", "description": "Injection, estrone, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1435", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, etidronate disodium, per 300 mg", "description": "Injection, etidronate disodium, per 300 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1436", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferric derisomaltose, 10 mg", "description": "Injection, ferric derisomaltose, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1437", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "description": "Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1438", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferric carboxymaltose, 1 mg", "description": "Injection, ferric carboxymaltose, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1439", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram", "description": "Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1442", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferric pyrophosphate citrate solution (triferic), 0.1 mg of iron", "description": "Injection, ferric pyrophosphate citrate solution (triferic), 0.1 mg of iron", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1443", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron", "description": "Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1444", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of iron", "description": "Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of iron", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1445", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tbo-filgrastim, 5 micrograms", "description": "Injection, tbo-filgrastim, 5 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1446", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tbo-filgrastim, 1 microgram", "description": "Injection, tbo-filgrastim, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1447", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trilaciclib, 1mg", "description": "Injection, trilaciclib, 1mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1448", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection fluconazole, 200 mg", "description": "Injection fluconazole, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fomepizole, 15 mg", "description": "Injection, fomepizole, 15 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1451", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fomivirsen sodium, intraocular, 1.65 mg", "description": "Injection, fomivirsen sodium, intraocular, 1.65 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fosaprepitant, 1 mg", "description": "Injection, fosaprepitant, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1453", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fosnetupitant 235 mg and palonosetron 0.25 mg", "description": "Injection, fosnetupitant 235 mg and palonosetron 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1454", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, foscarnet sodium, per 1000 mg", "description": "Injection, foscarnet sodium, per 1000 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gallium nitrate, 1 mg", "description": "Injection, gallium nitrate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1457", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, galsulfase, 1 mg", "description": "Injection, galsulfase, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1458", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg", "description": "Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1459", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gamma globulin, intramuscular, 1 cc", "description": "Injection, gamma globulin, intramuscular, 1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin (asceniv), 500 mg", "description": "Injection, immune globulin (asceniv), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1554", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin (cuvitru), 100 mg", "description": "Injection, immune globulin (cuvitru), 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1555", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin (bivigam), 500 mg", "description": "Injection, immune globulin (bivigam), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1556", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg", "description": "Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1557", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin (xembify), 100 mg", "description": "Injection, immune globulin (xembify), 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1558", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin (hizentra), 100 mg", "description": "Injection, immune globulin (hizentra), 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1559", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gamma globulin, intramuscular, over 10 cc", "description": "Injection, gamma globulin, intramuscular, over 10 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg", "description": "Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1561", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin (vivaglobin), 100 mg", "description": "Injection, immune globulin (vivaglobin), 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg", "description": "Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1566", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg", "description": "Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1568", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg", "description": "Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1569", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ganciclovir sodium, 500 mg", "description": "Injection, ganciclovir sodium, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml", "description": "Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1571", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg", "description": "Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1572", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml", "description": "Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1573", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin", "description": "Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1575", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, garamycin, gentamicin, up to 80 mg", "description": "Injection, garamycin, gentamicin, up to 80 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gatifloxacin, 10 mg", "description": "Injection, gatifloxacin, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, glatiramer acetate, 20 mg", "description": "Injection, glatiramer acetate, 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1595", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg", "description": "Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1599", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gold sodium thiomalate, up to 50 mg", "description": "Injection, gold sodium thiomalate, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, golimumab, 1 mg, for intravenous use", "description": "Injection, golimumab, 1 mg, for intravenous use", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1602", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, glucagon hydrochloride, per 1 mg", "description": "Injection, glucagon hydrochloride, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gonadorelin hydrochloride, per 100 mcg", "description": "Injection, gonadorelin hydrochloride, per 100 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, granisetron hydrochloride, 100 mcg", "description": "Injection, granisetron hydrochloride, 100 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, granisetron, extended-release, 0.1 mg", "description": "Injection, granisetron, extended-release, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, guselkumab, 1 mg", "description": "Injection, guselkumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, haloperidol, up to 5 mg", "description": "Injection, haloperidol, up to 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, haloperidol decanoate, per 50 mg", "description": "Injection, haloperidol decanoate, per 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, brexanolone, 1 mg", "description": "Injection, brexanolone, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hemin, 1 mg", "description": "Injection, hemin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, heparin sodium, (heparin lock flush), per 10 units", "description": "Injection, heparin sodium, (heparin lock flush), per 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, heparin sodium, per 1000 units", "description": "Injection, heparin sodium, per 1000 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1644", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dalteparin sodium, per 2500 iu", "description": "Injection, dalteparin sodium, per 2500 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1645", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, enoxaparin sodium, 10 mg", "description": "Injection, enoxaparin sodium, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fondaparinux sodium, 0.5 mg", "description": "Injection, fondaparinux sodium, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1652", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tinzaparin sodium, 1000 iu", "description": "Injection, tinzaparin sodium, 1000 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1655", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tetanus immune globulin, human, up to 250 units", "description": "Injection, tetanus immune globulin, human, up to 250 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, histrelin acetate, 10 micrograms", "description": "Injection, histrelin acetate, 10 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1675", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydrocortisone acetate, up to 25 mg", "description": "Injection, hydrocortisone acetate, up to 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydrocortisone sodium phosphate, up to 50 mg", "description": "Injection, hydrocortisone sodium phosphate, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydrocortisone sodium succinate, up to 100 mg", "description": "Injection, hydrocortisone sodium succinate, up to 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydroxyprogesterone caproate, 1 mg", "description": "Injection, hydroxyprogesterone caproate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1725", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydroxyprogesterone caproate, (makena), 10 mg", "description": "Injection, hydroxyprogesterone caproate, (makena), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1726", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg", "description": "Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1729", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, diazoxide, up to 300 mg", "description": "Injection, diazoxide, up to 300 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, meloxicam, 1 mg", "description": "Injection, meloxicam, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1738", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ibandronate sodium, 1 mg", "description": "Injection, ibandronate sodium, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ibuprofen, 100 mg", "description": "Injection, ibuprofen, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1741", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ibutilide fumarate, 1 mg", "description": "Injection, ibutilide fumarate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1742", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, idursulfase, 1 mg", "description": "Injection, idursulfase, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1743", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, icatibant, 1 mg", "description": "Injection, icatibant, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1744", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, infliximab, excludes biosimilar, 10 mg", "description": "Injection, infliximab, excludes biosimilar, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1745", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ibalizumab-uiyk, 10 mg", "description": "Injection, ibalizumab-uiyk, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1746", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, iron dextran, 50 mg", "description": "Injection, iron dextran, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1750", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, iron sucrose, 1 mg", "description": "Injection, iron sucrose, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1756", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, imiglucerase, 10 units", "description": "Injection, imiglucerase, 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1786", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, droperidol, up to 5 mg", "description": "Injection, droperidol, up to 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1790", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, propranolol hcl, up to 1 mg", "description": "Injection, propranolol hcl, up to 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, droperidol and fentanyl citrate, up to 2 ml ampule", "description": "Injection, droperidol and fentanyl citrate, up to 2 ml ampule", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, insulin, per 5 units", "description": "Injection, insulin, per 5 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1815", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin for administration through dme (i.e., insulin pump) per 50 units", "description": "Insulin for administration through dme (i.e., insulin pump) per 50 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1817", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, inebilizumab-cdon, 1 mg", "description": "Injection, inebilizumab-cdon, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1823", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, interferon beta-1a, 30 mcg", "description": "Injection, interferon beta-1a, 30 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1826", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, interferon beta-1b, 0.25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "description": "Injection, interferon beta-1b, 0.25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, isavuconazonium, 1 mg", "description": "Injection, isavuconazonium, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1833", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, itraconazole, 50 mg", "description": "Injection, itraconazole, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1835", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, kanamycin sulfate, up to 500 mg", "description": "Injection, kanamycin sulfate, up to 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, kanamycin sulfate, up to 75 mg", "description": "Injection, kanamycin sulfate, up to 75 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ketorolac tromethamine, per 15 mg", "description": "Injection, ketorolac tromethamine, per 15 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1885", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cephalothin sodium, up to 1 gram", "description": "Injection, cephalothin sodium, up to 1 gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lanreotide, 1 mg", "description": "Injection, lanreotide, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, laronidase, 0.1 mg", "description": "Injection, laronidase, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1931", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, furosemide, up to 20 mg", "description": "Injection, furosemide, up to 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aripiprazole lauroxil, 1 mg", "description": "Injection, aripiprazole lauroxil, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1942", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aripiprazole lauroxil, (aristada initio), 1 mg", "description": "Injection, aripiprazole lauroxil, (aristada initio), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1943", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aripiprazole lauroxil, (aristada), 1 mg", "description": "Injection, aripiprazole lauroxil, (aristada), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1944", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lepirudin, 50 mg", "description": "Injection, lepirudin, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1945", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, leuprolide acetate (for depot suspension), per 3.75 mg", "description": "Injection, leuprolide acetate (for depot suspension), per 3.75 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg", "description": "Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1951", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, levetiracetam, 10 mg", "description": "Injection, levetiracetam, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1953", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, levocarnitine, per 1 gm", "description": "Injection, levocarnitine, per 1 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1955", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, levofloxacin, 250 mg", "description": "Injection, levofloxacin, 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1956", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, levorphanol tartrate, up to 2 mg", "description": "Injection, levorphanol tartrate, up to 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hyoscyamine sulfate, up to 0.25 mg", "description": "Injection, hyoscyamine sulfate, up to 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, chlordiazepoxide hcl, up to 100 mg", "description": "Injection, chlordiazepoxide hcl, up to 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1990", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lidocaine hcl for intravenous infusion, 10 mg", "description": "Injection, lidocaine hcl for intravenous infusion, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lincomycin hcl, up to 300 mg", "description": "Injection, lincomycin hcl, up to 300 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, linezolid, 200 mg", "description": "Injection, linezolid, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lorazepam, 2 mg", "description": "Injection, lorazepam, 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Loxapine for inhalation, 1 mg", "description": "Loxapine for inhalation, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2062", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mannitol, 25% in 50 ml", "description": "Injection, mannitol, 25% in 50 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mecasermin, 1 mg", "description": "Injection, mecasermin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, meperidine hydrochloride, per 100 mg", "description": "Injection, meperidine hydrochloride, per 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, meperidine and promethazine hcl, up to 50 mg", "description": "Injection, meperidine and promethazine hcl, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mepolizumab, 1 mg", "description": "Injection, mepolizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2182", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, meropenem, 100 mg", "description": "Injection, meropenem, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, meropenem and vaborbactam, 10mg/10mg (20mg)", "description": "Injection, meropenem and vaborbactam, 10mg/10mg (20mg)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methylergonovine maleate, up to 0.2 mg", "description": "Injection, methylergonovine maleate, up to 0.2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methylnaltrexone, 0.1 mg", "description": "Injection, methylnaltrexone, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, micafungin sodium, 1 mg", "description": "Injection, micafungin sodium, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, midazolam hydrochloride, per 1 mg", "description": "Injection, midazolam hydrochloride, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, milrinone lactate, 5 mg", "description": "Injection, milrinone lactate, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, minocycline hydrochloride, 1 mg", "description": "Injection, minocycline hydrochloride, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, morphine sulfate, up to 10 mg", "description": "Injection, morphine sulfate, up to 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, morphine sulfate, 100mg", "description": "Injection, morphine sulfate, 100mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2271", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg", "description": "Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2274", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, morphine sulfate (preservative-free sterile solution), per 10 mg", "description": "Injection, morphine sulfate (preservative-free sterile solution), per 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ziconotide, 1 microgram", "description": "Injection, ziconotide, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2278", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, moxifloxacin, 100 mg", "description": "Injection, moxifloxacin, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nalbuphine hydrochloride, per 10 mg", "description": "Injection, nalbuphine hydrochloride, per 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, naloxone hydrochloride, per 1 mg", "description": "Injection, naloxone hydrochloride, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, naltrexone, depot form, 1 mg", "description": "Injection, naltrexone, depot form, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nandrolone decanoate, up to 50 mg", "description": "Injection, nandrolone decanoate, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, natalizumab, 1 mg", "description": "Injection, natalizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2323", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nesiritide, 0.1 mg", "description": "Injection, nesiritide, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nusinersen, 0.1 mg", "description": "Injection, nusinersen, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2326", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ocrelizumab, 1 mg", "description": "Injection, ocrelizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, octreotide, depot form for intramuscular injection, 1 mg", "description": "Injection, octreotide, depot form for intramuscular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2353", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg", "description": "Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2354", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oprelvekin, 5 mg", "description": "Injection, oprelvekin, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2355", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, omalizumab, 5 mg", "description": "Injection, omalizumab, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2357", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, olanzapine, long-acting, 1 mg", "description": "Injection, olanzapine, long-acting, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2358", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, orphenadrine citrate, up to 60 mg", "description": "Injection, orphenadrine citrate, up to 60 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, phenylephrine hcl, up to 1 ml", "description": "Injection, phenylephrine hcl, up to 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, chloroprocaine hydrochloride, per 30 ml", "description": "Injection, chloroprocaine hydrochloride, per 30 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ondansetron hydrochloride, per 1 mg", "description": "Injection, ondansetron hydrochloride, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2405", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oritavancin (kimyrsa), 10 mg", "description": "Injection, oritavancin (kimyrsa), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2406", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oritavancin (orbactiv), 10 mg", "description": "Injection, oritavancin (orbactiv), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2407", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oxymorphone hcl, up to 1 mg", "description": "Injection, oxymorphone hcl, up to 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, palifermin, 50 micrograms", "description": "Injection, palifermin, 50 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2425", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, paliperidone palmitate extended release, 1 mg", "description": "Injection, paliperidone palmitate extended release, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2426", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pamidronate disodium, per 30 mg", "description": "Injection, pamidronate disodium, per 30 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, papaverine hcl, up to 60 mg", "description": "Injection, papaverine hcl, up to 60 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2440", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oxytetracycline hcl, up to 50 mg", "description": "Injection, oxytetracycline hcl, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, palonosetron hcl, 25 mcg", "description": "Injection, palonosetron hcl, 25 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2469", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, paricalcitol, 1 mcg", "description": "Injection, paricalcitol, 1 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pasireotide long acting, 1 mg", "description": "Injection, pasireotide long acting, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegaptanib sodium, 0.3 mg", "description": "Injection, pegaptanib sodium, 0.3 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegademase bovine, 25 iu", "description": "Injection, pegademase bovine, 25 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegfilgrastim, 6 mg", "description": "Injection, pegfilgrastim, 6 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegloticase, 1 mg", "description": "Injection, pegloticase, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, penicillin g procaine, aqueous, up to 600,000 units", "description": "Injection, penicillin g procaine, aqueous, up to 600,000 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pentastarch, 10% solution, 100 ml", "description": "Injection, pentastarch, 10% solution, 100 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pentobarbital sodium, per 50 mg", "description": "Injection, pentobarbital sodium, per 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, penicillin g potassium, up to 600,000 units", "description": "Injection, penicillin g potassium, up to 600,000 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)", "description": "Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2543", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg", "description": "Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2545", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, peramivir, 1 mg", "description": "Injection, peramivir, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2547", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, promethazine hcl, up to 50 mg", "description": "Injection, promethazine hcl, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, phenobarbital sodium, up to 120 mg", "description": "Injection, phenobarbital sodium, up to 120 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, plerixafor, 1 mg", "description": "Injection, plerixafor, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oxytocin, up to 10 units", "description": "Injection, oxytocin, up to 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, desmopressin acetate, per 1 mcg", "description": "Injection, desmopressin acetate, per 1 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2597", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, prednisolone acetate, up to 1 ml", "description": "Injection, prednisolone acetate, up to 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tolazoline hcl, up to 25 mg", "description": "Injection, tolazoline hcl, up to 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, progesterone, per 50 mg", "description": "Injection, progesterone, per 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2675", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fluphenazine decanoate, up to 25 mg", "description": "Injection, fluphenazine decanoate, up to 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, procainamide hcl, up to 1 gm", "description": "Injection, procainamide hcl, up to 1 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2690", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oxacillin sodium, up to 250 mg", "description": "Injection, oxacillin sodium, up to 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, propofol, 10 mg", "description": "Injection, propofol, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2704", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, neostigmine methylsulfate, up to 0.5 mg", "description": "Injection, neostigmine methylsulfate, up to 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, protamine sulfate, per 10 mg", "description": "Injection, protamine sulfate, per 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, protein c concentrate, intravenous, human, 10 iu", "description": "Injection, protein c concentrate, intravenous, human, 10 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2724", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, protirelin, per 250 mcg", "description": "Injection, protirelin, per 250 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2725", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pralidoxime chloride, up to 1 gm", "description": "Injection, pralidoxime chloride, up to 1 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, phentolamine mesylate, up to 5 mg", "description": "Injection, phentolamine mesylate, up to 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, metoclopramide hcl, up to 10 mg", "description": "Injection, metoclopramide hcl, up to 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2765", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, quinupristin/dalfopristin, 500 mg (150/350)", "description": "Injection, quinupristin/dalfopristin, 500 mg (150/350)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ranibizumab, 0.1 mg", "description": "Injection, ranibizumab, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2778", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ranitidine hydrochloride, 25 mg", "description": "Injection, ranitidine hydrochloride, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rasburicase, 0.5 mg", "description": "Injection, rasburicase, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2783", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, regadenoson, 0.1 mg", "description": "Injection, regadenoson, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2785", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, reslizumab, 1 mg", "description": "Injection, reslizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2786", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml", "description": "Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2787", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)", "description": "Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2788", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)", "description": "Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2790", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu", "description": "Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2791", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu", "description": "Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2792", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rilonacept, 1 mg", "description": "Injection, rilonacept, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2793", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, risperidone (risperdal consta), 0.5 mg", "description": "Injection, risperidone (risperdal consta), 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2794", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ropivacaine hydrochloride, 1 mg", "description": "Injection, ropivacaine hydrochloride, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2795", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, romiplostim, 10 micrograms", "description": "Injection, romiplostim, 10 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2796", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rolapitant, 0.5 mg", "description": "Injection, rolapitant, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2797", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, risperidone, (perseris), 0.5 mg", "description": "Injection, risperidone, (perseris), 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2798", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methocarbamol, up to 10 ml", "description": "Injection, methocarbamol, up to 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sincalide, 5 micrograms", "description": "Injection, sincalide, 5 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2805", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, theophylline, per 40 mg", "description": "Injection, theophylline, per 40 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sargramostim (gm-csf), 50 mcg", "description": "Injection, sargramostim (gm-csf), 50 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2820", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sebelipase alfa, 1 mg", "description": "Injection, sebelipase alfa, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, secretin, synthetic, human, 1 microgram", "description": "Injection, secretin, synthetic, human, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, siltuximab, 10 mg", "description": "Injection, siltuximab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2860", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aurothioglucose, up to 50 mg", "description": "Injection, aurothioglucose, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg", "description": "Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2916", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methylprednisolone sodium succinate, up to 40 mg", "description": "Injection, methylprednisolone sodium succinate, up to 40 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2920", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, methylprednisolone sodium succinate, up to 125 mg", "description": "Injection, methylprednisolone sodium succinate, up to 125 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, somatrem, 1 mg", "description": "Injection, somatrem, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, somatropin, 1 mg", "description": "Injection, somatropin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2941", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, promazine hcl, up to 25 mg", "description": "Injection, promazine hcl, up to 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, reteplase, 18.1 mg", "description": "Injection, reteplase, 18.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2993", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, streptokinase, per 250,000 iu", "description": "Injection, streptokinase, per 250,000 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2995", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alteplase recombinant, 1 mg", "description": "Injection, alteplase recombinant, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2997", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, streptomycin, up to 1 gm", "description": "Injection, streptomycin, up to 1 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fentanyl citrate, 0.1 mg", "description": "Injection, fentanyl citrate, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "description": "Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)", "description": "Injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, eptinezumab-jjmr, 1 mg", "description": "Injection, eptinezumab-jjmr, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, taliglucerase alfa, 10 units", "description": "Injection, taliglucerase alfa, 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pentazocine, 30 mg", "description": "Injection, pentazocine, 30 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tedizolid phosphate, 1 mg", "description": "Injection, tedizolid phosphate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, telavancin, 10 mg", "description": "Injection, telavancin, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3095", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tenecteplase, 1 mg", "description": "Injection, tenecteplase, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, terbutaline sulfate, up to 1 mg", "description": "Injection, terbutaline sulfate, up to 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, teriparatide, 10 mcg", "description": "Injection, teriparatide, 10 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, romosozumab-aqqg, 1 mg", "description": "Injection, romosozumab-aqqg, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3111", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone enanthate, up to 100 mg", "description": "Injection, testosterone enanthate, up to 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone enanthate, 1 mg", "description": "Injection, testosterone enanthate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone enanthate, up to 200 mg", "description": "Injection, testosterone enanthate, up to 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone suspension, up to 50 mg", "description": "Injection, testosterone suspension, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone undecanoate, 1 mg", "description": "Injection, testosterone undecanoate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, testosterone propionate, up to 100 mg", "description": "Injection, testosterone propionate, up to 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, chlorpromazine hcl, up to 50 mg", "description": "Injection, chlorpromazine hcl, up to 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial", "description": "Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, teprotumumab-trbw, 10 mg", "description": "Injection, teprotumumab-trbw, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3241", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tigecycline, 1 mg", "description": "Injection, tigecycline, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3243", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tildrakizumab, 1 mg", "description": "Injection, tildrakizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tirofiban hcl, 0.25 mg", "description": "Injection, tirofiban hcl, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trimethobenzamide hcl, up to 200 mg", "description": "Injection, trimethobenzamide hcl, up to 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tobramycin sulfate, up to 80 mg", "description": "Injection, tobramycin sulfate, up to 80 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tocilizumab, 1 mg", "description": "Injection, tocilizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3262", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, torsemide, 10 mg/ml", "description": "Injection, torsemide, 10 mg/ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, thiethylperazine maleate, up to 10 mg", "description": "Injection, thiethylperazine maleate, up to 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, treprostinil, 1 mg", "description": "Injection, treprostinil, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triamcinolone acetonide, preservative free, 1 mg", "description": "Injection, triamcinolone acetonide, preservative free, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triamcinolone acetonide, not otherwise specified, 10 mg", "description": "Injection, triamcinolone acetonide, not otherwise specified, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triamcinolone diacetate, per 5 mg", "description": "Injection, triamcinolone diacetate, per 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3302", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triamcinolone hexacetonide, per 5 mg", "description": "Injection, triamcinolone hexacetonide, per 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3303", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg", "description": "Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3304", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trimetrexate glucuronate, per 25 mg", "description": "Injection, trimetrexate glucuronate, per 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3305", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, perphenazine, up to 5 mg", "description": "Injection, perphenazine, up to 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triptorelin pamoate, 3.75 mg", "description": "Injection, triptorelin pamoate, 3.75 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triptorelin, extended-release, 3.75 mg", "description": "Injection, triptorelin, extended-release, 3.75 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3316", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, spectinomycin dihydrochloride, up to 2 gm", "description": "Injection, spectinomycin dihydrochloride, up to 2 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, urea, up to 40 gm", "description": "Injection, urea, up to 40 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, urofollitropin, 75 iu", "description": "Injection, urofollitropin, 75 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3355", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ustekinumab, for subcutaneous injection, 1 mg", "description": "Ustekinumab, for subcutaneous injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3357", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ustekinumab, for intravenous injection, 1 mg", "description": "Ustekinumab, for intravenous injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3358", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, diazepam, up to 5 mg", "description": "Injection, diazepam, up to 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, urokinase, 5000 iu vial", "description": "Injection, urokinase, 5000 iu vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, iv, urokinase, 250,000 i.u. vial", "description": "Injection, iv, urokinase, 250,000 i.u. vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3365", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, vancomycin hcl, 500 mg", "description": "Injection, vancomycin hcl, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, vedolizumab, 1 mg", "description": "Injection, vedolizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, velaglucerase alfa, 100 units", "description": "Injection, velaglucerase alfa, 100 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3385", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, verteporfin, 0.1 mg", "description": "Injection, verteporfin, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3396", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, vestronidase alfa-vjbk, 1 mg", "description": "Injection, vestronidase alfa-vjbk, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3397", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, voretigene neparvovec-rzyl, 1 billion vector genomes", "description": "Injection, voretigene neparvovec-rzyl, 1 billion vector genomes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3398", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes", "description": "Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3399", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triflupromazine hcl, up to 20 mg", "description": "Injection, triflupromazine hcl, up to 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydroxyzine hcl, up to 25 mg", "description": "Injection, hydroxyzine hcl, up to 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, thiamine hcl, 100 mg", "description": "Injection, thiamine hcl, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3411", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pyridoxine hcl, 100 mg", "description": "Injection, pyridoxine hcl, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3415", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg", "description": "Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, phytonadione (vitamin k), per 1 mg", "description": "Injection, phytonadione (vitamin k), per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, voriconazole, 10 mg", "description": "Injection, voriconazole, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hyaluronidase, up to 150 units", "description": "Injection, hyaluronidase, up to 150 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)", "description": "Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3471", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hyaluronidase, ovine, preservative free, per 1000 usp units", "description": "Injection, hyaluronidase, ovine, preservative free, per 1000 usp units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3472", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hyaluronidase, recombinant, 1 usp unit", "description": "Injection, hyaluronidase, recombinant, 1 usp unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3473", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, magnesium sulfate, per 500 mg", "description": "Injection, magnesium sulfate, per 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3475", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, potassium chloride, per 2 meq", "description": "Injection, potassium chloride, per 2 meq", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, zidovudine, 10 mg", "description": "Injection, zidovudine, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ziprasidone mesylate, 10 mg", "description": "Injection, ziprasidone mesylate, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3486", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, zoledronic acid, 1 mg", "description": "Injection, zoledronic acid, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3489", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unclassified drugs", "description": "Unclassified drugs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Edetate disodium, per 150 mg", "description": "Edetate disodium, per 150 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasal vaccine inhalation", "description": "Nasal vaccine inhalation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug administered through a metered dose inhaler", "description": "Drug administered through a metered dose inhaler", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3535", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laetrile, amygdalin, vitamin b17", "description": "Laetrile, amygdalin, vitamin b17", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unclassified biologics", "description": "Unclassified biologics", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unclassified drug or biological used for esrd on dialysis", "description": "Unclassified drug or biological used for esrd on dialysis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3591", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, normal saline solution , 1000 cc", "description": "Infusion, normal saline solution , 1000 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, normal saline solution, sterile (500 ml = 1 unit)", "description": "Infusion, normal saline solution, sterile (500 ml = 1 unit)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "5% dextrose/normal saline (500 ml = 1 unit)", "description": "5% dextrose/normal saline (500 ml = 1 unit)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, normal saline solution, 250 cc", "description": "Infusion, normal saline solution, 250 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "5% dextrose/water (500 ml = 1 unit)", "description": "5% dextrose/water (500 ml = 1 unit)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, d5w, 1000 cc", "description": "Infusion, d5w, 1000 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, dextran 40, 500 ml", "description": "Infusion, dextran 40, 500 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, dextran 75, 500 ml", "description": "Infusion, dextran 75, 500 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ringers lactate infusion, up to 1000 cc", "description": "Ringers lactate infusion, up to 1000 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "5% dextrose in lactated ringers infusion, up to 1000 cc", "description": "5% dextrose in lactated ringers infusion, up to 1000 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hypertonic saline solution, 1 ml", "description": "Hypertonic saline solution, 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity", "description": "Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7168", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg", "description": "Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7169", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, emicizumab-kxwh, 0.5 mg", "description": "Injection, emicizumab-kxwh, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor x, (human), 1 i.u.", "description": "Injection, factor x, (human), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, human fibrinogen concentrate (fibryga), 1 mg", "description": "Injection, human fibrinogen concentrate (fibryga), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7177", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, human fibrinogen concentrate, not otherwise specified, 1 mg", "description": "Injection, human fibrinogen concentrate, not otherwise specified, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7178", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco", "description": "Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7179", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor xiii (antihemophilic factor, human), 1 i.u.", "description": "Injection, factor xiii (antihemophilic factor, human), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor xiii a-subunit, (recombinant), per iu", "description": "Injection, factor xiii a-subunit, (recombinant), per iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu", "description": "Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7182", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco", "description": "Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7183", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.", "description": "Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.", "description": "Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, von willebrand factor complex (humate-p), per iu vwf:rco", "description": "Injection, von willebrand factor complex (humate-p), per iu vwf:rco", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7187", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.", "description": "Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7188", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram", "description": "Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7189", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor viii (antihemophilic factor, human) per i.u.", "description": "Factor viii (antihemophilic factor, human) per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor viii (antihemophilic factor (porcine)), per i.u.", "description": "Factor viii (antihemophilic factor (porcine)), per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7191", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified", "description": "Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7192", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor ix (antihemophilic factor, purified, non-recombinant) per i.u.", "description": "Factor ix (antihemophilic factor, purified, non-recombinant) per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7193", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor ix, complex, per i.u.", "description": "Factor ix, complex, per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7194", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified", "description": "Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7195", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, antithrombin recombinant, 50 i.u.", "description": "Injection, antithrombin recombinant, 50 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7196", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antithrombin iii (human), per i.u.", "description": "Antithrombin iii (human), per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7197", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anti-inhibitor, per i.u.", "description": "Anti-inhibitor, per i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7198", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemophilia clotting factor, not otherwise classified", "description": "Hemophilia clotting factor, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu", "description": "Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.", "description": "Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.", "description": "Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu", "description": "Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu", "description": "Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii fc fusion protein (recombinant), per iu", "description": "Injection, factor viii fc fusion protein (recombinant), per iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.", "description": "Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.", "description": "Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.", "description": "Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.", "description": "Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.", "description": "Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram", "description": "Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each", "description": "Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7294", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each", "description": "Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7295", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg", "description": "Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7296", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg", "description": "Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7297", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg", "description": "Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7298", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intrauterine copper contraceptive", "description": "Intrauterine copper contraceptive", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg", "description": "Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levonorgestrel-releasing intrauterine contraceptive system, 52 mg", "description": "Levonorgestrel-releasing intrauterine contraceptive system, 52 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7302", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contraceptive supply, hormone containing vaginal ring, each", "description": "Contraceptive supply, hormone containing vaginal ring, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7303", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contraceptive supply, hormone containing patch, each", "description": "Contraceptive supply, hormone containing patch, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7304", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levonorgestrel (contraceptive) implant system, including implants and supplies", "description": "Levonorgestrel (contraceptive) implant system, including implants and supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7306", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Etonogestrel (contraceptive) implant system, including implant and supplies", "description": "Etonogestrel (contraceptive) implant system, including implant and supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7307", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)", "description": "Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7308", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram", "description": "Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7309", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ganciclovir, 4.5 mg, long-acting implant", "description": "Ganciclovir, 4.5 mg, long-acting implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg", "description": "Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7311", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dexamethasone, intravitreal implant, 0.1 mg", "description": "Injection, dexamethasone, intravitreal implant, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7312", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg", "description": "Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7313", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg", "description": "Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7314", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mitomycin, ophthalmic, 0.2 mg", "description": "Mitomycin, ophthalmic, 0.2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ocriplasmin, 0.125 mg", "description": "Injection, ocriplasmin, 0.125 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7316", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7318", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose", "description": "Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7321", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7322", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose", "description": "Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7323", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose", "description": "Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7324", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, gel-one, for intra-articular injection, per dose", "description": "Hyaluronan or derivative, gel-one, for intra-articular injection, per dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7326", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, monovisc, for intra-articular injection, per dose", "description": "Hyaluronan or derivative, monovisc, for intra-articular injection, per dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7327", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg", "description": "Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7328", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7329", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Autologous cultured chondrocytes, implant", "description": "Autologous cultured chondrocytes, implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7331", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7332", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, visco-3, for intra-articular injection, per dose", "description": "Hyaluronan or derivative, visco-3, for intra-articular injection, per dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7333", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Capsaicin 8% patch, per 10 square centimeters", "description": "Capsaicin 8% patch, per 10 square centimeters", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7335", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Capsaicin 8% patch, per square centimeter", "description": "Capsaicin 8% patch, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7336", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml", "description": "Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Instillation, ciprofloxacin otic suspension, 6 mg", "description": "Instillation, ciprofloxacin otic suspension, 6 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7342", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg", "description": "Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7345", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bimatoprost, intracameral implant, 1 microgram", "description": "Injection, bimatoprost, intracameral implant, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7351", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Afamelanotide implant, 1 mg", "description": "Afamelanotide implant, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7352", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mometasone furoate sinus implant, 10 micrograms", "description": "Mometasone furoate sinus implant, 10 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7401", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mometasone furoate sinus implant, (sinuva), 10 micrograms", "description": "Mometasone furoate sinus implant, (sinuva), 10 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7402", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Azathioprine, oral, 50 mg", "description": "Azathioprine, oral, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Azathioprine, parenteral, 100 mg", "description": "Azathioprine, parenteral, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cyclosporine, oral, 100 mg", "description": "Cyclosporine, oral, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg", "description": "Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg", "description": "Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Muromonab-cd3, parenteral, 5 mg", "description": "Muromonab-cd3, parenteral, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prednisone, oral, per 5 mg", "description": "Prednisone, oral, per 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tacrolimus, immediate release, oral, 1 mg", "description": "Tacrolimus, immediate release, oral, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg", "description": "Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methylprednisolone oral, per 4 mg", "description": "Methylprednisolone oral, per 4 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prednisolone oral, per 5 mg", "description": "Prednisolone oral, per 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg", "description": "Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7511", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prednisone, immediate release or delayed release, oral, 1 mg", "description": "Prednisone, immediate release or delayed release, oral, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Daclizumab, parenteral, 25 mg", "description": "Daclizumab, parenteral, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cyclosporine, oral, 25 mg", "description": "Cyclosporine, oral, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cyclosporin, parenteral, 250 mg", "description": "Cyclosporin, parenteral, 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7516", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mycophenolate mofetil, oral, 250 mg", "description": "Mycophenolate mofetil, oral, 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7517", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mycophenolic acid, oral, 180 mg", "description": "Mycophenolic acid, oral, 180 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7518", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sirolimus, oral, 1 mg", "description": "Sirolimus, oral, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tacrolimus, parenteral, 5 mg", "description": "Tacrolimus, parenteral, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7525", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Everolimus, oral, 0.25 mg", "description": "Everolimus, oral, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7527", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immunosuppressive drug, not otherwise classified", "description": "Immunosuppressive drug, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7599", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Acetylcysteine, inhalation solution, compounded product, administered through dme, unit dose form, per gram", "description": "Acetylcysteine, inhalation solution, compounded product, administered through dme, unit 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{ "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms", "description": "Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levalbuterol, inhalation solution, compounded product, administered through dme, concentrated form, 0.5 mg", "description": "Levalbuterol, inhalation solution, compounded product, administered through dme, concentrated form, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7607", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram", "description": "Acetylcysteine, inhalation solution, fda-approved final product, 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"negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg", "description": "Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg", "description": "Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7611", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg", "description": "Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7612", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg", "description": "Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7613", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg", "description": "Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7614", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg", "description": "Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme", "description": "Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Beclomethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Beclomethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Betamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Betamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg", "description": "Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg", "description": "Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "description": "Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bitolterol mesylate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Bitolterol mesylate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams", "description": "Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams", "description": "Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram", "description": "Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7633", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Budesonide, inhalation solution, compounded product, administered through dme, concentrated form, per 0.25 milligram", "description": "Budesonide, inhalation solution, compounded product, administered through dme, concentrated form, per 0.25 milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7634", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Atropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "description": "Atropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Atropine, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Atropine, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dexamethasone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "description": "Dexamethasone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram", "description": "Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7639", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms", "description": "Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Flunisolide, inhalation solution, compounded product, administered through dme, unit dose, per milligram", "description": "Flunisolide, inhalation solution, compounded product, administered through dme, unit dose, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "description": "Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7643", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram", "description": "Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7644", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7645", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Isoetharine hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "description": "Isoetharine hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7647", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram", "description": "Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 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"negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Isoetharine hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Isoetharine hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Isoproterenol hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "description": "Isoproterenol hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7657", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram", "description": "Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7658", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram", "description": "Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7659", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Isoproterenol hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Isoproterenol hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mannitol, administered through an inhaler, 5 mg", "description": "Mannitol, administered through an inhaler, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7665", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metaproterenol sulfate, inhalation solution, compounded product, concentrated form, per 10 milligrams", "description": "Metaproterenol sulfate, inhalation solution, compounded product, concentrated form, per 10 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7667", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 10 milligrams", "description": "Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 10 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7668", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams", "description": "Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7669", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metaproterenol sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams", "description": "Metaproterenol sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg", "description": "Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7674", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pentamidine isethionate, inhalation solution, compounded product, administered through dme, unit dose form, per 300 mg", "description": "Pentamidine isethionate, inhalation solution, compounded product, administered through dme, unit dose form, per 300 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7676", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram", "description": "Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7677", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terbutaline sulfate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "description": "Terbutaline sulfate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7681", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams", "description": "Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7682", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "description": "Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7683", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "description": "Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7684", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams", "description": "Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7685", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg", "description": "Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7686", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Noc drugs, inhalation solution administered through dme", "description": "Noc drugs, inhalation solution administered through dme", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Noc drugs, other than inhalation drugs, administered through dme", "description": "Noc drugs, other than inhalation drugs, administered through dme", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7799", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compounded drug, not otherwise classified", "description": "Compounded drug, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antiemetic drug, rectal/suppository, not otherwise specified", "description": "Antiemetic drug, rectal/suppository, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8498", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prescription drug, oral, non chemotherapeutic, nos", "description": "Prescription drug, oral, non chemotherapeutic, nos", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aprepitant, oral, 5 mg", "description": "Aprepitant, oral, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Busulfan; oral, 2 mg", "description": "Busulfan; oral, 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cabergoline, oral, 0.25 mg", "description": "Cabergoline, oral, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Capecitabine, oral, 150 mg", "description": "Capecitabine, oral, 150 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Capecitabine, oral, 500 mg", "description": "Capecitabine, oral, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8521", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cyclophosphamide; oral, 25 mg", "description": "Cyclophosphamide; oral, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dexamethasone, oral, 0.25 mg", "description": "Dexamethasone, oral, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Etoposide; oral, 50 mg", "description": "Etoposide; oral, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fludarabine phosphate, oral, 10 mg", "description": "Fludarabine phosphate, oral, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gefitinib, oral, 250 mg", "description": "Gefitinib, oral, 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8565", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antiemetic drug, oral, not otherwise specified", "description": "Antiemetic drug, oral, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8597", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Melphalan; oral, 2 mg", "description": "Melphalan; oral, 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methotrexate; oral, 2.5 mg", "description": "Methotrexate; oral, 2.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nabilone, oral, 1 mg", "description": "Nabilone, oral, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Netupitant 300 mg and palonosetron 0.5 mg, oral", "description": "Netupitant 300 mg and palonosetron 0.5 mg, oral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8655", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rolapitant, oral, 1 mg", "description": "Rolapitant, oral, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Temozolomide, oral, 5 mg", "description": "Temozolomide, oral, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Topotecan, oral, 0.25 mg", "description": "Topotecan, oral, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8705", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prescription drug, oral, chemotherapeutic, nos", "description": "Prescription drug, oral, chemotherapeutic, nos", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J8999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, doxorubicin hydrochloride, 10 mg", "description": "Injection, doxorubicin hydrochloride, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alemtuzumab, 10 mg", "description": "Injection, alemtuzumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aldesleukin, per single use vial", "description": "Injection, aldesleukin, per single use vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, arsenic trioxide, 1 mg", "description": "Injection, arsenic trioxide, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, asparaginase (erwinaze), 1,000 iu", "description": "Injection, asparaginase (erwinaze), 1,000 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, asparaginase, not otherwise specified, 10,000 units", "description": "Injection, asparaginase, not otherwise specified, 10,000 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, atezolizumab, 10 mg", "description": "Injection, atezolizumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, avelumab, 10 mg", "description": "Injection, avelumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, azacitidine, 1 mg", "description": "Injection, azacitidine, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, clofarabine, 1 mg", "description": "Injection, clofarabine, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bcg live intravesical instillation, 1 mg", "description": "Bcg live intravesical instillation, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bcg (intravesical) per instillation", "description": "Bcg (intravesical) per instillation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, belinostat, 10 mg", "description": "Injection, belinostat, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bendamustine hcl (treanda), 1 mg", "description": "Injection, bendamustine hcl (treanda), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bendamustine hcl (bendeka), 1 mg", "description": "Injection, bendamustine hcl (bendeka), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bevacizumab, 10 mg", "description": "Injection, bevacizumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg", "description": "Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, belantamab mafodotin-blmf, 0.5 mg", "description": "Injection, belantamab mafodotin-blmf, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, blinatumomab, 1 microgram", "description": "Injection, blinatumomab, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bleomycin sulfate, 15 units", "description": "Injection, bleomycin sulfate, 15 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bortezomib (velcade), 0.1 mg", "description": "Injection, bortezomib (velcade), 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, brentuximab vedotin, 1 mg", "description": "Injection, brentuximab vedotin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cabazitaxel, 1 mg", "description": "Injection, cabazitaxel, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bortezomib, not otherwise specified, 0.1 mg", "description": "Injection, bortezomib, not otherwise specified, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, carboplatin, 50 mg", "description": "Injection, carboplatin, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, carfilzomib, 1 mg", "description": "Injection, carfilzomib, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, carmustine, 100 mg", "description": "Injection, carmustine, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cetuximab, 10 mg", "description": "Injection, cetuximab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, copanlisib, 1 mg", "description": "Injection, copanlisib, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9057", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cisplatin, powder or solution, 10 mg", "description": "Injection, cisplatin, powder or solution, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cladribine, per 1 mg", "description": "Injection, cladribine, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9065", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cyclophosphamide, 100 mg", "description": "Cyclophosphamide, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cytarabine liposome, 10 mg", "description": "Injection, cytarabine liposome, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9098", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cytarabine, 100 mg", "description": "Injection, cytarabine, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, calaspargase pegol-mknl, 10 units", "description": "Injection, calaspargase pegol-mknl, 10 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9118", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cemiplimab-rwlc, 1 mg", "description": "Injection, cemiplimab-rwlc, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9119", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, dactinomycin, 0.5 mg", "description": "Injection, dactinomycin, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dacarbazine, 100 mg", "description": "Dacarbazine, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, daratumumab, 10 mg and hyaluronidase-fihj", "description": "Injection, daratumumab, 10 mg and hyaluronidase-fihj", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9144", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, daratumumab, 10 mg", "description": "Injection, daratumumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, daunorubicin, 10 mg", "description": "Injection, daunorubicin, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, daunorubicin citrate, liposomal formulation, 10 mg", "description": "Injection, daunorubicin citrate, liposomal formulation, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9151", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine", "description": "Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, degarelix, 1 mg", "description": "Injection, degarelix, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9155", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, denileukin diftitox, 300 micrograms", "description": "Injection, denileukin diftitox, 300 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, diethylstilbestrol diphosphate, 250 mg", "description": "Injection, diethylstilbestrol diphosphate, 250 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9165", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, docetaxel, 1 mg", "description": "Injection, docetaxel, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, durvalumab, 10 mg", "description": "Injection, durvalumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9173", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, elliotts' b solution, 1 ml", "description": "Injection, elliotts' b solution, 1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, elotuzumab, 1 mg", "description": "Injection, elotuzumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9176", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, enfortumab vedotin-ejfv, 0.25 mg", "description": "Injection, enfortumab vedotin-ejfv, 0.25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9177", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epirubicin hcl, 2 mg", "description": "Injection, epirubicin hcl, 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9178", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, eribulin mesylate, 0.1 mg", "description": "Injection, eribulin mesylate, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9179", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, etoposide, 10 mg", "description": "Injection, etoposide, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fludarabine phosphate, 50 mg", "description": "Injection, fludarabine phosphate, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fluorouracil, 500 mg", "description": "Injection, fluorouracil, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gemcitabine hydrochloride, (infugem), 100 mg", "description": "Injection, gemcitabine hydrochloride, (infugem), 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9198", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gemcitabine hydrochloride (infugem), 200 mg", "description": "Injection, gemcitabine hydrochloride (infugem), 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, floxuridine, 500 mg", "description": "Injection, floxuridine, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg", "description": "Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Goserelin acetate implant, per 3.6 mg", "description": "Goserelin acetate implant, per 3.6 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gemtuzumab ozogamicin, 0.1 mg", "description": "Injection, gemtuzumab ozogamicin, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mogamulizumab-kpkc, 1 mg", "description": "Injection, mogamulizumab-kpkc, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, irinotecan liposome, 1 mg", "description": "Injection, irinotecan liposome, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, irinotecan, 20 mg", "description": "Injection, irinotecan, 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ixabepilone, 1 mg", "description": "Injection, ixabepilone, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ifosfamide, 1 gram", "description": "Injection, ifosfamide, 1 gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mesna, 200 mg", "description": "Injection, mesna, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, emapalumab-lzsg, 1 mg", "description": "Injection, emapalumab-lzsg, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, idarubicin hydrochloride, 5 mg", "description": "Injection, idarubicin hydrochloride, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, interferon alfacon-1, recombinant, 1 microgram", "description": "Injection, interferon alfacon-1, recombinant, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, interferon, alfa-2a, recombinant, 3 million units", "description": "Injection, interferon, alfa-2a, recombinant, 3 million units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, interferon, alfa-2b, recombinant, 1 million units", "description": "Injection, interferon, alfa-2b, recombinant, 1 million units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu", "description": "Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, interferon, gamma 1-b, 3 million units", "description": "Injection, interferon, gamma 1-b, 3 million units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leuprolide acetate (for depot suspension), 7.5 mg", "description": "Leuprolide acetate (for depot suspension), 7.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9217", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leuprolide acetate, per 1 mg", "description": "Leuprolide acetate, per 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9218", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leuprolide acetate implant, 65 mg", "description": "Leuprolide acetate implant, 65 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9219", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, lurbinectedin, 0.1 mg", "description": "Injection, lurbinectedin, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9223", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Histrelin implant (vantas), 50 mg", "description": "Histrelin implant (vantas), 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Histrelin implant (supprelin la), 50 mg", "description": "Histrelin implant (supprelin la), 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9226", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, isatuximab-irfc, 10 mg", "description": "Injection, isatuximab-irfc, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9227", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ipilimumab, 1 mg", "description": "Injection, ipilimumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9228", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, inotuzumab ozogamicin, 0.1 mg", "description": "Injection, inotuzumab ozogamicin, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9229", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg", "description": "Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, melphalan hydrochloride, not otherwise specified, 50 mg", "description": "Injection, melphalan hydrochloride, not otherwise specified, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, melphalan (evomela), 1 mg", "description": "Injection, melphalan (evomela), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, melphalan flufenamide, 1mg", "description": "Injection, melphalan flufenamide, 1mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methotrexate sodium, 5 mg", "description": "Methotrexate sodium, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methotrexate sodium, 50 mg", "description": "Methotrexate sodium, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nelarabine, 50 mg", "description": "Injection, nelarabine, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9261", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, omacetaxine mepesuccinate, 0.01 mg", "description": "Injection, omacetaxine mepesuccinate, 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9262", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, oxaliplatin, 0.5 mg", "description": "Injection, oxaliplatin, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9263", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, paclitaxel protein-bound particles, 1 mg", "description": "Injection, paclitaxel protein-bound particles, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9264", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, paclitaxel, 30 mg", "description": "Injection, paclitaxel, 30 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegaspargase, per single dose vial", "description": "Injection, pegaspargase, per single dose vial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9266", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, paclitaxel, 1 mg", "description": "Injection, paclitaxel, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9267", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pentostatin, 10 mg", "description": "Injection, pentostatin, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9268", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tagraxofusp-erzs, 10 micrograms", "description": "Injection, tagraxofusp-erzs, 10 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9269", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, plicamycin, 2.5 mg", "description": "Injection, plicamycin, 2.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pembrolizumab, 1 mg", "description": "Injection, pembrolizumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9271", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mitomycin, 5 mg", "description": "Injection, mitomycin, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mitomycin pyelocalyceal instillation, 1 mg", "description": "Mitomycin pyelocalyceal instillation, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9281", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, olaratumab, 10 mg", "description": "Injection, olaratumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, mitoxantrone hydrochloride, per 5 mg", "description": "Injection, mitoxantrone hydrochloride, per 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9293", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, necitumumab, 1 mg", "description": "Injection, necitumumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9295", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nivolumab, 1 mg", "description": "Injection, nivolumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9299", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, gemtuzumab ozogamicin, 5 mg", "description": "Injection, gemtuzumab ozogamicin, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, obinutuzumab, 10 mg", "description": "Injection, obinutuzumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ofatumumab, 10 mg", "description": "Injection, ofatumumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9302", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, panitumumab, 10 mg", "description": "Injection, panitumumab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9303", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pemetrexed (pemfexy), 10 mg", "description": "Injection, pemetrexed (pemfexy), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9304", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pemetrexed, not otherwise specified, 10 mg", "description": "Injection, pemetrexed, not otherwise specified, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9305", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pertuzumab, 1 mg", "description": "Injection, pertuzumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9306", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pralatrexate, 1 mg", "description": "Injection, pralatrexate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9307", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ramucirumab, 5 mg", "description": "Injection, ramucirumab, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9308", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, polatuzumab vedotin-piiq, 1 mg", "description": "Injection, polatuzumab vedotin-piiq, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9309", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rituximab, 100 mg", "description": "Injection, rituximab, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rituximab 10 mg and hyaluronidase", "description": "Injection, rituximab 10 mg and hyaluronidase", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9311", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rituximab, 10 mg", "description": "Injection, rituximab, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9312", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, moxetumomab pasudotox-tdfk, 0.01 mg", "description": "Injection, moxetumomab pasudotox-tdfk, 0.01 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9313", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, romidepsin, 1 mg", "description": "Injection, romidepsin, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg", "description": "Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9316", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sacituzumab govitecan-hziy, 2.5 mg", "description": "Injection, sacituzumab govitecan-hziy, 2.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9317", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, romidepsin, non-lyophilized, 0.1 mg", "description": "Injection, romidepsin, non-lyophilized, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9318", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, romidepsin, lyophilized, 0.1 mg", "description": "Injection, romidepsin, lyophilized, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9319", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, streptozocin, 1 gram", "description": "Injection, streptozocin, 1 gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, talimogene laherparepvec, per 1 million plaque forming units", "description": "Injection, talimogene laherparepvec, per 1 million plaque forming units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, temozolomide, 1 mg", "description": "Injection, temozolomide, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9328", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, temsirolimus, 1 mg", "description": "Injection, temsirolimus, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, thiotepa, 15 mg", "description": "Injection, thiotepa, 15 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, naxitamab-gqgk, 1 mg", "description": "Injection, naxitamab-gqgk, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9348", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tafasitamab-cxix, 2 mg", "description": "Injection, tafasitamab-cxix, 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9349", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, topotecan, 0.1 mg", "description": "Injection, topotecan, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9351", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trabectedin, 0.1 mg", "description": "Injection, trabectedin, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9352", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, margetuximab-cmkb, 5 mg", "description": "Injection, margetuximab-cmkb, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9353", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ado-trastuzumab emtansine, 1 mg", "description": "Injection, ado-trastuzumab emtansine, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9354", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trastuzumab, excludes biosimilar, 10 mg", "description": "Injection, trastuzumab, excludes biosimilar, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9355", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trastuzumab, 10 mg and hyaluronidase-oysk", "description": "Injection, trastuzumab, 10 mg and hyaluronidase-oysk", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9356", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, valrubicin, intravesical, 200 mg", "description": "Injection, valrubicin, intravesical, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9357", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fam-trastuzumab deruxtecan-nxki, 1 mg", "description": "Injection, fam-trastuzumab deruxtecan-nxki, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9358", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, vinblastine sulfate, 1 mg", "description": "Injection, vinblastine sulfate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vincristine sulfate, 1 mg", "description": "Vincristine sulfate, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, vincristine sulfate liposome, 1 mg", "description": "Injection, vincristine sulfate liposome, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9371", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, vinorelbine tartrate, 10 mg", "description": "Injection, vinorelbine tartrate, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fulvestrant, 25 mg", "description": "Injection, fulvestrant, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9395", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ziv-aflibercept, 1 mg", "description": "Injection, ziv-aflibercept, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, porfimer sodium, 75 mg", "description": "Injection, porfimer sodium, 75 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Not otherwise classified, antineoplastic drugs", "description": "Not otherwise classified, antineoplastic drugs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J9999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standard wheelchair", "description": "Standard wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standard hemi (low seat) wheelchair", "description": "Standard hemi (low seat) wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lightweight wheelchair", "description": "Lightweight wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High strength, lightweight wheelchair", "description": "High strength, lightweight wheelchair", 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"service_code": [ "11" ] } ] } ] }, { "name": "Heavy duty wheelchair", "description": "Heavy duty wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extra heavy duty wheelchair", "description": "Extra heavy duty wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Custom manual wheelchair/base", "description": "Custom manual wheelchair/base", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other manual wheelchair/base", "description": "Other manual wheelchair/base", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standard - weight frame motorized/power wheelchair", "description": "Standard - weight frame motorized/power wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking", "description": "Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lightweight portable motorized/power wheelchair", "description": "Lightweight portable motorized/power wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Custom motorized/power wheelchair base", "description": "Custom motorized/power wheelchair base", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other motorized/power wheelchair base", "description": "Other motorized/power wheelchair base", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Detachable, non-adjustable height armrest, replacement only, each", "description": "Detachable, non-adjustable height armrest, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Detachable, adjustable height armrest, base, replacement only, each", "description": "Detachable, adjustable height armrest, base, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Detachable, adjustable height armrest, upper portion, replacement only, each", "description": "Detachable, adjustable height armrest, upper portion, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Arm pad, replacement only, each", "description": "Arm pad, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fixed, adjustable height armrest, pair", "description": "Fixed, adjustable height armrest, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High mount flip-up footrest, each", "description": "High mount flip-up footrest, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg strap, each", "description": "Leg strap, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg strap, h style, each", "description": "Leg strap, h style, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adjustable angle footplate, each", "description": "Adjustable angle footplate, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Large size footplate, each", "description": "Large size footplate, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Standard size footplate, replacement only, each", "description": "Standard size footplate, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Footrest, lower extension tube, replacement only, each", "description": "Footrest, lower extension tube, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Footrest, upper hanger bracket, replacement only, each", "description": "Footrest, upper hanger bracket, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Footrest, complete assembly, replacement only, each", "description": "Footrest, complete assembly, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elevating legrest, lower extension tube, replacement only, each", "description": "Elevating legrest, lower extension tube, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elevating legrest, upper hanger bracket, replacement only, each", "description": "Elevating legrest, upper hanger bracket, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ratchet assembly, replacement only", "description": "Ratchet assembly, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cam release assembly, footrest or legrest, replacement only, each", "description": "Cam release assembly, footrest or legrest, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0051", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Swingaway, detachable footrests, replacement only, each", "description": "Swingaway, detachable footrests, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elevating footrests, articulating (telescoping), each", "description": "Elevating footrests, articulating (telescoping), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0053", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Seat height less than 17\" or equal to or greater than 21\" for a high strength, lightweight, or ultralightweight wheelchair", "description": "Seat height less than 17\" or equal to or greater than 21\" for a high strength, lightweight, or ultralightweight wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0056", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spoke protectors, each", "description": "Spoke protectors, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0065", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each", "description": "Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0069", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each", "description": "Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Front caster assembly, complete, with pneumatic tire, replacement only, each", "description": "Front caster assembly, complete, with pneumatic tire, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0071", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Front caster assembly, complete, with semi-pneumatic tire, replacement only, each", "description": "Front caster assembly, complete, with semi-pneumatic tire, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0072", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Caster pin lock, each", "description": "Caster pin lock, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0073", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Front caster assembly, complete, with solid tire, replacement only, each", "description": "Front caster assembly, complete, with solid tire, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0077", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drive belt for power wheelchair, replacement only", "description": "Drive belt for power wheelchair, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0098", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iv hanger, each", "description": "Iv hanger, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair component or accessory, not otherwise specified", "description": "Wheelchair component or accessory, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0108", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elevating leg rests, pair (for use with capped rental wheelchair base)", "description": "Elevating leg rests, pair (for use with capped rental wheelchair base)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0195", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)", "description": "Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Temporary replacement for patient owned equipment being repaired, any type", "description": "Temporary replacement for patient owned equipment being repaired, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0462", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each", "description": "Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0552", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service", "description": "Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0553", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system", "description": "Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0554", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each", "description": "Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0601", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each", "description": "Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0602", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each", "description": "Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0603", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each", "description": "Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each", "description": "Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0605", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Automatic external defibrillator, with integrated electrocardiogram analysis, garment type", "description": "Automatic external defibrillator, with integrated electrocardiogram analysis, garment type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement battery for automated external defibrillator, garment type only, each", "description": "Replacement battery for automated external defibrillator, garment type only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0607", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement garment for use with automated external defibrillator, each", "description": "Replacement garment for use with automated external defibrillator, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0608", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement electrodes for use with automated external defibrillator, garment type only, each", "description": "Replacement electrodes for use with automated external defibrillator, garment type only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0609", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac", "description": "Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0669", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each", "description": "Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0672", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Controlled dose inhalation drug delivery system", "description": "Controlled dose inhalation drug delivery system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)", "description": "Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0733", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing", "description": "Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0738", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes", "description": "Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0739", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes", "description": "Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Suction pump, home model, portable, for use on wounds", "description": "Suction pump, home model, portable, for use on wounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0743", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less", "description": "Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0744", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches", "description": "Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0745", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches", "description": "Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0746", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds", "description": "Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds", "description": "Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0801", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds", "description": "Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0802", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds", "description": "Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0806", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds", "description": "Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0807", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds", "description": "Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0808", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power operated vehicle, not otherwise classified", "description": "Power operated vehicle, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0812", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0813", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0814", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0815", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0816", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0820", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0821", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0822", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0823", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds", "description": "Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0824", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds", "description": "Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0825", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds", "description": "Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0826", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds", "description": "Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0827", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", 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sling/solid seat/back, patient weight capacity 601 pounds or more", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0864", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0868", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0869", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds", "description": "Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0870", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds", "description": "Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0871", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0877", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0878", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds", "description": "Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0879", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds", "description": "Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0880", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0884", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds", "description": "Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0885", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds", "description": "Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0886", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds", "description": "Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds", "description": "Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0891", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power wheelchair, not otherwise classified", "description": "Power wheelchair, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0898", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power mobility device, not coded by dme pdac or does not meet criteria", "description": "Power mobility device, not coded by dme pdac or does not meet criteria", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0899", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Customized durable medical equipment, other than wheelchair", "description": "Customized durable medical equipment, other than wheelchair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf", "description": "Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0901", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf", "description": "Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0902", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each", "description": "For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0903", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type", "description": "Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cranial electrotherapy stimulation (ces) system, includes all supplies and accessories, any type", "description": "Cranial electrotherapy stimulation (ces) system, includes all supplies and accessories, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Whirlpool tub, walk-in, portable", "description": "Whirlpool tub, walk-in, portable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low frequency ultrasonic diathermy treatment device for home use, includes all components and accessories", "description": "Low frequency ultrasonic diathermy treatment device for home use, includes all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable collection and storage bag for breast milk, any size, any type, each", "description": "Disposable collection and storage bag for breast milk, any size, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system", "description": "Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors", "description": "Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Speech volume modulation system, any type, including all components and accessories", "description": "Speech volume modulation system, any type, including all components and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each", "description": "Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Activation device for intraurethral drainage device with valve, replacement only, each", "description": "Activation device for intraurethral drainage device with valve, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Charger and base station for intraurethral activation device, replacement only", "description": "Charger and base station for intraurethral activation device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enema tube, with or without adapter, any type, replacement only, each", "description": "Enema tube, with or without adapter, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control", "description": "Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, adductus positioning device, adjustable", "description": "Foot, adductus positioning device, adjustable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve", "description": "Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Monthly supplies for use of device coded at k1016", "description": "Monthly supplies for use of device coded at k1016", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External upper limb tremor stimulator of the peripheral nerves of the wrist", "description": "External upper limb tremor stimulator of the peripheral nerves of the wrist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Monthly supplies for use of device coded at k1018", "description": "Monthly supplies for use of device coded at k1018", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-invasive vagus nerve stimulator", "description": "Non-invasive vagus nerve stimulator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Exsufflation belt, includes all supplies and accessories", "description": "Exsufflation belt, includes all supplies and accessories", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type", "description": "Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm", "description": "Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-pneumatic compression controller with sequential calibrated gradient pressure", "description": "Non-pneumatic compression controller with sequential calibrated gradient pressure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-pneumatic sequential compression garment, full arm", "description": "Non-pneumatic sequential compression garment, full arm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical", "description": "Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment", "description": "Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K1027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated", "description": "Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment", "description": "Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)", "description": "Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, flexible, thermoplastic collar, molded to patient", "description": "Cervical, flexible, thermoplastic collar, molded to patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, semi-rigid, adjustable (plastic collar)", "description": "Cervical, semi-rigid, adjustable (plastic collar)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)", "description": "Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf", "description": "Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, collar, molded to patient model", "description": "Cervical, collar, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf", "description": "Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0172", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf", "description": "Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0174", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, multiple post collar, occipital/mandibular supports, adjustable", "description": "Cervical, multiple post collar, occipital/mandibular supports, adjustable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)", "description": "Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension", "description": "Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Thoracic, rib belt, custom fabricated", "description": "Thoracic, rib belt, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf", "description": "Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated", "description": "Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0454", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf", "description": "Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0456", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf", "description": "Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0457", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "description": "Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0458", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "description": "Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0462", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "description": "Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0464", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0466", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf", "description": "Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0467", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0468", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf", "description": "Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0469", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal, and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment", "description": "Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal, and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment", "description": "Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0472", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated", "description": "Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated", "description": "Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0482", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated", "description": "Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0484", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated", "description": "Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0486", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment", "description": "Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0488", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment", "description": "Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "description": "Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0491", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "description": "Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0492", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf", "description": "Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0621", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated", "description": "Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf", "description": "Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0623", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated", "description": "Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf", "description": "Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "description": "Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated", "description": "Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated", "description": "Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0633", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated", "description": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0634", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment", "description": "Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated", "description": "Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated", "description": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0639", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated", "description": "Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "description": "Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "description": "Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "description": "Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0643", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "description": "Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0648", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "description": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0649", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "description": "Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf", "description": "Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0651", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)", "description": "Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)", "description": "Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Halo procedure, cervical halo incorporated into jacket vest", "description": "Halo procedure, cervical halo incorporated into jacket vest", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Halo procedure, cervical halo incorporated into plaster body jacket", "description": "Halo procedure, cervical halo incorporated into plaster body jacket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0820", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Halo procedure, cervical halo incorporated into milwaukee type orthosis", "description": "Halo procedure, cervical halo incorporated into milwaukee type orthosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material", "description": "Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0859", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to halo procedure, replacement liner/interface material", "description": "Addition to halo procedure, replacement liner/interface material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0861", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, corset front", "description": "Tlso, corset front", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lso, corset front", "description": "Lso, corset front", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0972", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tlso, full corset", "description": "Tlso, full corset", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0974", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lso, full corset", "description": "Lso, full corset", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0976", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Axillary crutch extension", "description": "Axillary crutch extension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0978", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Peroneal straps, prefabricated, off-the-shelf, pair", "description": "Peroneal straps, prefabricated, off-the-shelf, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)", "description": "Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Protective body sock, prefabricated, off-the-shelf, each", "description": "Protective body sock, prefabricated, off-the-shelf, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0984", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to spinal orthosis, not otherwise specified", "description": "Addition to spinal orthosis, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L0999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model", "description": "Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment", "description": "Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment", "description": "Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling", "description": "Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, kyphosis pad", "description": "Addition to ctlso or scoliosis orthosis, kyphosis pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, kyphosis pad, floating", "description": "Addition to ctlso or scoliosis orthosis, kyphosis pad, floating", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, lumbar bolster pad", "description": "Addition to ctlso or scoliosis orthosis, lumbar bolster pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad", "description": "Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, sternal pad", "description": "Addition to ctlso or scoliosis orthosis, sternal pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, thoracic pad", "description": "Addition to ctlso or scoliosis orthosis, thoracic pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, trapezius sling", "description": "Addition to ctlso or scoliosis orthosis, trapezius sling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, outrigger", "description": "Addition to ctlso or scoliosis orthosis, outrigger", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions", "description": "Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1085", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, lumbar sling", "description": "Addition to ctlso or scoliosis orthosis, lumbar sling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather", "description": "Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model", "description": "Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to ctlso, scoliosis orthosis, cover for upright, each", "description": "Addition to ctlso, scoliosis orthosis, cover for upright, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only", "description": "Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), lateral thoracic extension", "description": "Addition to tlso, (low profile), lateral thoracic extension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), anterior thoracic extension", "description": "Addition to tlso, (low profile), anterior thoracic extension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), milwaukee type superstructure", "description": "Addition to tlso, (low profile), milwaukee type superstructure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), lumbar derotation pad", "description": "Addition to tlso, (low profile), lumbar derotation pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), anterior asis pad", "description": "Addition to tlso, (low profile), anterior asis pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), anterior thoracic derotation pad", "description": "Addition to tlso, (low profile), anterior thoracic derotation pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), abdominal pad", "description": "Addition to tlso, (low profile), abdominal pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), rib gusset (elastic), each", "description": "Addition to tlso, (low profile), rib gusset (elastic), each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to tlso, (low profile), lateral trochanteric pad", "description": "Addition to tlso, (low profile), lateral trochanteric pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other scoliosis procedure, body jacket molded to patient model", "description": "Other scoliosis procedure, body jacket molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Other scoliosis procedure, post-operative body jacket", "description": "Other scoliosis procedure, post-operative body jacket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spinal orthosis, not otherwise specified", "description": "Spinal orthosis, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise", "description": "Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated", "description": "Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated", "description": "Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment", "description": "Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type", "description": "Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1652", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment", "description": "Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated", "description": "Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated", "description": "Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1685", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment", "description": "Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1686", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment", "description": "Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1690", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Legg perthes orthosis, (toronto type), custom fabricated", "description": "Legg perthes orthosis, (toronto type), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Legg perthes orthosis, (newington type), custom fabricated", "description": "Legg perthes orthosis, (newington type), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated", "description": "Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Legg perthes orthosis, (scottish rite type), custom fabricated", "description": "Legg perthes orthosis, (scottish rite type), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Legg perthes orthosis, (patten bottom type), custom fabricated", "description": "Legg perthes orthosis, (patten bottom type), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1755", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, elastic with joints, prefabricated, off-the-shelf", "description": "Knee orthosis, elastic with joints, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1812", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment", "description": "Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1820", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf", "description": "Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment", "description": "Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1831", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1832", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf", "description": "Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1833", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, without knee joint, rigid, custom fabricated", "description": "Knee orthosis, without knee joint, rigid, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1834", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf", "description": "Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1836", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated", "description": "Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1843", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated", "description": "Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1844", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1845", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated", "description": "Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1846", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1847", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf", "description": "Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1848", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, swedish type, prefabricated, off-the-shelf", "description": "Knee orthosis, swedish type, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf", "description": "Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1851", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf", "description": "Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1852", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)", "description": "Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1860", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated", "description": "Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf", "description": "Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1902", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated", "description": "Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1904", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf", "description": "Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1906", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated", "description": "Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1907", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment", "description": "Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated", "description": "Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1920", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment", "description": "Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment", "description": "Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1932", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, plastic or other material, custom fabricated", "description": "Ankle foot orthosis, plastic or other material, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated", "description": "Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1945", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated", "description": "Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment", "description": "Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1951", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated", "description": "Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, plastic with ankle joint, custom fabricated", "description": "Ankle foot orthosis, plastic with ankle joint, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment", "description": "Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1971", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated", "description": "Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated", "description": "Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L1990", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated", "description": "Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated", "description": "Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated", "description": "Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated", "description": "Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated", "description": "Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated", "description": "Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated", "description": "Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment", "description": "Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated", "description": "Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated", "description": "Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated", "description": "Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated", "description": "Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated", "description": "Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated", "description": "Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated", "description": "Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated", "description": "Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated", "description": "Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated", "description": "Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2106", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated", "description": "Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2108", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment", "description": "Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment", "description": "Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2114", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment", "description": "Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2116", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated", "description": "Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated", "description": "Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2128", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment", "description": "Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2132", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment", "description": "Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2134", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment", "description": "Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2136", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints", "description": "Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity fracture orthosis, drop lock knee joint", "description": "Addition to lower extremity fracture orthosis, drop lock knee joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2182", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity fracture orthosis, limited motion knee joint", "description": "Addition to lower extremity fracture orthosis, limited motion knee joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2184", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type", "description": "Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity fracture orthosis, quadrilateral brim", "description": "Addition to lower extremity fracture orthosis, quadrilateral brim", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2188", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity fracture orthosis, waist belt", "description": "Addition to lower extremity fracture orthosis, waist belt", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt", "description": "Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2192", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, limited ankle motion, each joint", "description": "Addition to lower extremity, limited ankle motion, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint", "description": "Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint", "description": "Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, split flat caliper stirrups and plate attachment", "description": "Addition to lower extremity, split flat caliper stirrups and plate attachment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only", "description": "Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2232", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, round caliper and plate attachment", "description": "Addition to lower extremity, round caliper and plate attachment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, foot plate, molded to patient model, stirrup attachment", "description": "Addition to lower extremity, foot plate, molded to patient model, stirrup attachment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, reinforced solid stirrup (scott-craig type)", "description": "Addition to lower extremity, reinforced solid stirrup (scott-craig type)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, long tongue stirrup", "description": "Addition to lower extremity, long tongue stirrup", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad", "description": "Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined", "description": "Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, molded inner boot", "description": "Addition to lower extremity, molded inner boot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable", "description": "Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, abduction bar-straight", "description": "Addition to lower extremity, abduction bar-straight", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only", "description": "Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only", "description": "Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, anterior swing band", "description": "Addition to lower extremity, anterior swing band", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2335", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pre-tibial shell, molded to patient model", "description": "Addition to lower extremity, pre-tibial shell, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)", "description": "Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, extended steel shank", "description": "Addition to lower extremity, extended steel shank", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, patten bottom", "description": "Addition to lower extremity, patten bottom", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, torsion control, ankle joint and half solid stirrup", "description": "Addition to lower extremity, torsion control, ankle joint and half solid stirrup", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2375", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, torsion control, straight knee joint, each joint", "description": "Addition to lower extremity, torsion control, straight knee joint, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, straight knee joint, heavy duty, each joint", "description": "Addition to lower extremity, straight knee joint, heavy duty, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2385", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint", "description": "Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2387", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, offset knee joint, each joint", "description": "Addition to lower extremity, offset knee joint, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, offset knee joint, heavy duty, each joint", "description": "Addition to lower extremity, offset knee joint, heavy duty, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2395", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, suspension sleeve", "description": "Addition to lower extremity orthosis, suspension sleeve", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2397", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to knee joint, drop lock, each", "description": "Addition to knee joint, drop lock, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2405", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint", "description": "Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2415", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint", "description": "Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2425", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to knee joint, ratchet lock for active and progressive knee extension, each joint", "description": "Addition to knee joint, ratchet lock for active and progressive knee extension, each joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to knee joint, lift loop for drop lock ring", "description": "Addition to knee joint, lift loop for drop lock ring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2492", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring", "description": "Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model", "description": "Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted", "description": "Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model", "description": "Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2525", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted", "description": "Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2526", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thigh-weight bearing, lacer, non-molded", "description": "Addition to lower extremity, thigh-weight bearing, lacer, non-molded", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model", "description": "Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thigh/weight bearing, high roll cuff", "description": "Addition to lower extremity, thigh/weight bearing, high roll cuff", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each", "description": "Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, pelvic sling", "description": "Addition to lower extremity, pelvic control, pelvic sling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each", "description": "Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each", "description": "Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, hip joint, heavy duty, each", "description": "Addition to lower extremity, pelvic control, hip joint, heavy duty, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each", "description": "Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each", "description": "Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables", "description": "Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables", "description": "Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, band and belt, unilateral", "description": "Addition to lower extremity, pelvic control, band and belt, unilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic control, band and belt, bilateral", "description": "Addition to lower extremity, pelvic control, band and belt, bilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, pelvic and thoracic control, gluteal pad, each", "description": "Addition to lower extremity, pelvic and thoracic control, gluteal pad, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thoracic control, thoracic band", "description": "Addition to lower extremity, thoracic control, thoracic band", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thoracic control, paraspinal uprights", "description": "Addition to lower extremity, thoracic control, paraspinal uprights", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, thoracic control, lateral support uprights", "description": "Addition to lower extremity, thoracic control, lateral support uprights", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, plating chrome or nickel, per bar", "description": "Addition to lower extremity orthosis, plating chrome or nickel, per bar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2750", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only", "description": "Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2755", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)", "description": "Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthotic side bar disconnect device, per bar", "description": "Orthotic side bar disconnect device, per bar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2768", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, non-corrosive finish, per bar", "description": "Addition to lower extremity orthosis, non-corrosive finish, per bar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, drop lock retainer, each", "description": "Addition to lower extremity orthosis, drop lock retainer, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2785", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, knee control, full kneecap", "description": "Addition to lower extremity orthosis, knee control, full kneecap", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2795", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only", "description": "Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, knee control, condylar pad", "description": "Addition to lower extremity orthosis, knee control, condylar pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, soft interface for molded plastic, below knee section", "description": "Addition to lower extremity orthosis, soft interface for molded plastic, below knee section", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2820", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, soft interface for molded plastic, above knee section", "description": "Addition to lower extremity orthosis, soft interface for molded plastic, above knee section", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, tibial length sock, fracture or equal, each", "description": "Addition to lower extremity orthosis, tibial length sock, fracture or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity orthosis, femoral length sock, fracture or equal, each", "description": "Addition to lower extremity orthosis, femoral length sock, fracture or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each", "description": "Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2861", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lower extremity orthoses, not otherwise specified", "description": "Lower extremity orthoses, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L2999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each", "description": "Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, insert, removable, molded to patient model, spenco, each", "description": "Foot, insert, removable, molded to patient model, spenco, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, insert, removable, molded to patient model, plastazote or equal, each", "description": "Foot, insert, removable, molded to patient model, plastazote or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, insert, removable, molded to patient model, silicone gel, each", "description": "Foot, insert, removable, molded to patient model, silicone gel, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, insert, removable, molded to patient model, longitudinal arch support, each", "description": "Foot, insert, removable, molded to patient model, longitudinal arch support, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each", "description": "Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, insert, removable, formed to patient foot, each", "description": "Foot, insert, removable, formed to patient foot, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each", "description": "Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, arch support, removable, premolded, longitudinal, each", "description": "Foot, arch support, removable, premolded, longitudinal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, arch support, removable, premolded, metatarsal, each", "description": "Foot, arch support, removable, premolded, metatarsal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, arch support, removable, premolded, longitudinal/ metatarsal, each", "description": "Foot, arch support, removable, premolded, longitudinal/ metatarsal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, arch support, non-removable attached to shoe, longitudinal, each", "description": "Foot, arch support, non-removable attached to shoe, longitudinal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, arch support, non-removable attached to shoe, metatarsal, each", "description": "Foot, arch support, non-removable attached to shoe, metatarsal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each", "description": "Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hallus-valgus night dynamic splint, prefabricated, off-the-shelf", "description": "Hallus-valgus night dynamic splint, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, abduction rotation bar, including shoes", "description": "Foot, abduction rotation bar, including shoes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, abduction rotation bar, without shoes", "description": "Foot, abduction rotation bar, without shoes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, adjustable shoe-styled positioning device", "description": "Foot, adjustable shoe-styled positioning device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each", "description": "Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe, oxford with supinator or pronator, infant", "description": "Orthopedic shoe, oxford with supinator or pronator, infant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe, oxford with supinator or pronator, child", "description": "Orthopedic shoe, oxford with supinator or pronator, child", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe, oxford with supinator or pronator, junior", "description": "Orthopedic shoe, oxford with supinator or pronator, junior", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe, hightop with supinator or pronator, infant", "description": "Orthopedic shoe, hightop with supinator or pronator, infant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe, hightop with supinator or pronator, child", "description": "Orthopedic shoe, hightop with supinator or pronator, child", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe, hightop with supinator or pronator, junior", "description": "Orthopedic shoe, hightop with supinator or pronator, junior", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical boot, each, infant", "description": "Surgical boot, each, infant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical boot, each, child", "description": "Surgical boot, each, child", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical boot, each, junior", "description": "Surgical boot, each, junior", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Benesch boot, pair, infant", "description": "Benesch boot, pair, infant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Benesch boot, pair, child", "description": "Benesch boot, pair, child", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Benesch boot, pair, junior", "description": "Benesch boot, pair, junior", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, ladies shoe, oxford, each", "description": "Orthopedic footwear, ladies shoe, oxford, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, ladies shoe, depth inlay, each", "description": "Orthopedic footwear, ladies shoe, depth inlay, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, ladies shoe, hightop, depth inlay, each", "description": "Orthopedic footwear, ladies shoe, hightop, depth inlay, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3217", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, mens shoe, oxford, each", "description": "Orthopedic footwear, mens shoe, oxford, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3219", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, mens shoe, depth inlay, each", "description": "Orthopedic footwear, mens shoe, depth inlay, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, mens shoe, hightop, depth inlay, each", "description": "Orthopedic footwear, mens shoe, hightop, depth inlay, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)", "description": "Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3224", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)", "description": "Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, custom shoe, depth inlay, each", "description": "Orthopedic footwear, custom shoe, depth inlay, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each", "description": "Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, shoe molded to patient model, silicone shoe, each", "description": "Foot, shoe molded to patient model, silicone shoe, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3251", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each", "description": "Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3252", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot, molded shoe plastazote (or similar) custom fitted, each", "description": "Foot, molded shoe plastazote (or similar) custom fitted, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3253", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-standard size or width", "description": "Non-standard size or width", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3254", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-standard size or length", "description": "Non-standard size or length", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic footwear, additional charge for split size", "description": "Orthopedic footwear, additional charge for split size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgical boot/shoe, each", "description": "Surgical boot/shoe, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plastazote sandal, each", "description": "Plastazote sandal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lift, elevation, heel, tapered to metatarsals, per inch", "description": "Lift, elevation, heel, tapered to metatarsals, per inch", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lift, elevation, heel and sole, neoprene, per inch", "description": "Lift, elevation, heel and sole, neoprene, per inch", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lift, elevation, heel and sole, cork, per inch", "description": "Lift, elevation, heel and sole, cork, per inch", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lift, elevation, metal extension (skate)", "description": "Lift, 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{100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lift, elevation, heel, per inch", "description": "Lift, elevation, heel, per inch", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3334", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel wedge, sach", "description": "Heel wedge, sach", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel wedge", "description": "Heel wedge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sole wedge, outside sole", "description": "Sole wedge, outside sole", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sole wedge, between sole", "description": "Sole wedge, between sole", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clubfoot wedge", "description": "Clubfoot wedge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Outflare wedge", "description": "Outflare wedge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metatarsal bar wedge, rocker", "description": "Metatarsal bar wedge, rocker", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metatarsal bar wedge, between sole", "description": "Metatarsal bar wedge, between sole", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Full sole and heel wedge, between sole", "description": "Full sole and heel wedge, between sole", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, counter, plastic reinforced", "description": "Heel, counter, plastic reinforced", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, counter, leather reinforced", "description": "Heel, counter, leather reinforced", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3440", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, sach cushion type", "description": "Heel, sach cushion type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, new leather, standard", "description": "Heel, new leather, standard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, new rubber, standard", "description": "Heel, new rubber, standard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, thomas with wedge", "description": "Heel, thomas with wedge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, thomas extended to ball", "description": "Heel, thomas extended to ball", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, pad and depression for spur", "description": "Heel, pad and depression for spur", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Heel, pad, removable for spur", "description": "Heel, pad, removable for spur", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, insole, leather", "description": "Orthopedic shoe addition, insole, leather", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, insole, rubber", "description": "Orthopedic shoe addition, insole, rubber", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, insole, felt covered with leather", "description": "Orthopedic shoe addition, insole, felt covered with leather", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, sole, half", "description": "Orthopedic shoe addition, sole, half", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, sole, full", "description": "Orthopedic shoe addition, sole, full", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, toe tap standard", "description": "Orthopedic shoe addition, toe tap standard", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, toe tap, horseshoe", "description": "Orthopedic shoe addition, toe tap, horseshoe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, special extension to instep (leather with eyelets)", "description": "Orthopedic shoe addition, special extension to instep (leather with eyelets)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, convert instep to velcro closure", "description": "Orthopedic shoe addition, convert instep to velcro closure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, convert firm shoe counter to soft counter", "description": "Orthopedic shoe addition, convert firm shoe counter to soft counter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe addition, march bar", "description": "Orthopedic shoe addition, march bar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3595", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer of an orthosis from one shoe to another, caliper plate, existing", "description": "Transfer of an orthosis from one shoe to another, caliper plate, existing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer of an orthosis from one shoe to another, caliper plate, new", "description": "Transfer of an orthosis from one shoe to another, caliper plate, new", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer of an orthosis from one shoe to another, solid stirrup, existing", "description": "Transfer of an orthosis from one shoe to another, solid stirrup, existing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer of an orthosis from one shoe to another, solid stirrup, new", "description": "Transfer of an orthosis from one shoe to another, solid stirrup, new", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes", "description": "Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthopedic shoe, modification, addition or transfer, not otherwise specified", "description": "Orthopedic shoe, modification, addition or transfer, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3649", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf", "description": "Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf", "description": "Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf", "description": "Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3671", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3674", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf", "description": "Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3675", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3677", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf", "description": "Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3678", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3702", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf", "description": "Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated", "description": "Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3720", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated", "description": "Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated", "description": "Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3740", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf", "description": "Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3761", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf", "description": "Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3762", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3763", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3764", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3765", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3766", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment", "description": "Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3806", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3807", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment", "description": "Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3808", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type", "description": "Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3809", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each", "description": "Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3891", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated", "description": "Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated", "description": "Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3901", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand finger orthosis, external powered, electric, custom fabricated", "description": "Wrist hand finger orthosis, external powered, electric, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3904", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3905", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3906", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf", "description": "Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3908", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf", "description": "Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3912", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3913", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3915", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf", "description": "Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3916", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3917", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf", "description": "Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3918", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3919", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3921", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3923", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf", "description": "Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3924", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf", "description": "Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3925", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf", "description": "Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3927", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3929", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf", "description": "Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment", "description": "Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3931", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment", "description": "Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3933", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment", "description": "Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3935", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition of joint to upper extremity orthosis, any material; per joint", "description": "Addition of joint to upper extremity orthosis, any material; per joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3956", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3961", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3962", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3967", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3971", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3973", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3975", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3976", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3977", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "description": "Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3978", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment", "description": "Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments", "description": "Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3981", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment", "description": "Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment", "description": "Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3984", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity orthosis, sock, fracture or equal, each", "description": "Addition to upper extremity orthosis, sock, fracture or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3995", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper limb orthosis, not otherwise specified", "description": "Upper limb orthosis, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L3999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace girdle for spinal orthosis (ctlso or so)", "description": "Replace girdle for spinal orthosis (ctlso or so)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement strap, any orthosis, includes all components, any length, any type", "description": "Replacement strap, any orthosis, includes all components, any length, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace trilateral socket brim", "description": "Replace trilateral socket brim", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace quadrilateral socket brim, molded to patient model", "description": "Replace quadrilateral socket brim, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace quadrilateral socket brim, custom fitted", "description": "Replace quadrilateral socket brim, custom fitted", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace molded thigh lacer, for custom fabricated orthosis only", "description": "Replace molded thigh lacer, for custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace non-molded thigh lacer, for custom fabricated orthosis only", "description": "Replace non-molded thigh lacer, for custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace molded calf lacer, for custom fabricated orthosis only", "description": "Replace molded calf lacer, for custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace non-molded calf lacer, for custom fabricated orthosis only", "description": "Replace non-molded calf lacer, for custom fabricated orthosis only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace high roll cuff", "description": "Replace high roll cuff", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace proximal and distal upright for kafo", "description": "Replace proximal and distal upright for kafo", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace metal bands kafo, proximal thigh", "description": "Replace metal bands kafo, proximal thigh", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace metal bands kafo-afo, calf or distal thigh", "description": "Replace metal bands kafo-afo, calf or distal thigh", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace leather cuff kafo, proximal thigh", "description": "Replace leather cuff kafo, proximal thigh", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace leather cuff kafo-afo, calf or distal thigh", "description": "Replace leather cuff kafo-afo, calf or distal thigh", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace pretibial shell", "description": "Replace pretibial shell", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair of orthotic device, labor component, per 15 minutes", "description": "Repair of orthotic device, labor component, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair of orthotic device, repair or replace minor parts", "description": "Repair of orthotic device, repair or replace minor parts", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf", "description": "Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf", "description": "Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4361", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumatic full leg splint, prefabricated, off-the-shelf", "description": "Pneumatic full leg splint, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4386", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf", "description": "Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4387", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement, soft interface material, static afo", "description": "Replacement, soft interface material, static afo", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4392", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replace soft interface material, foot drop splint", "description": "Replace soft interface material, foot drop splint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4394", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "description": "Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4396", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf", "description": "Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4397", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf", "description": "Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4398", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated", "description": "Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L4631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Partial foot, shoe insert with longitudinal arch, toe filler", "description": "Partial foot, shoe insert with longitudinal arch, toe filler", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Partial foot, molded socket, ankle height, with toe filler", "description": "Partial foot, molded socket, ankle height, with toe filler", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Partial foot, molded socket, tibial tubercle height, with toe filler", "description": "Partial foot, molded socket, tibial tubercle height, with toe filler", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle, symes, molded socket, sach foot", "description": "Ankle, symes, molded socket, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle, symes, metal frame, molded leather socket, articulated ankle/foot", "description": "Ankle, symes, metal frame, molded leather socket, articulated ankle/foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below knee, molded socket, shin, sach foot", "description": "Below knee, molded socket, shin, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below knee, plastic socket, joints and thigh lacer, sach foot", "description": "Below knee, plastic socket, joints and thigh lacer, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot", "description": "Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot", "description": "Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above knee, molded socket, single axis constant friction knee, shin, sach foot", "description": "Above knee, molded socket, single axis constant friction knee, shin, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each", "description": "Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each", "description": "Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot", "description": "Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot", "description": "Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot", "description": "Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot", "description": "Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below knee, molded socket, shin, sach foot, endoskeletal system", "description": "Below knee, molded socket, shin, sach foot, endoskeletal system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system", "description": "Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5312", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee", "description": "Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5321", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot", "description": "Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5331", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot", "description": "Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5341", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee", "description": "Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment", "description": "Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation", "description": "Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment", "description": "Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee", "description": "Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee", "description": "Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed", "description": "Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed", "description": "Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model", "description": "Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed", "description": "Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model", "description": "Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket", "description": "Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5535", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model", "description": "Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model", "description": "Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed", "description": "Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model", "description": "Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket", "description": "Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5585", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model", "description": "Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model", "description": "Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5595", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model", "description": "Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, endoskeletal system, above knee, hydracadence system", "description": "Addition to lower extremity, endoskeletal system, above knee, hydracadence system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control", "description": "Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5611", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control", "description": "Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5613", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control", "description": "Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5614", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control", "description": "Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5616", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each", "description": "Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5617", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, test socket, symes", "description": "Addition to lower extremity, test socket, symes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5618", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, test socket, below knee", "description": "Addition to lower extremity, test socket, below knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, test socket, knee disarticulation", "description": "Addition to lower extremity, test socket, knee disarticulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, test socket, above knee", "description": "Addition to lower extremity, test socket, above knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, test socket, hip disarticulation", "description": "Addition to lower extremity, test socket, hip disarticulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, test socket, hemipelvectomy", "description": "Addition to lower extremity, test socket, hemipelvectomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, acrylic socket", "description": "Addition to lower extremity, below knee, acrylic socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, symes type, expandable wall socket", "description": "Addition to lower extremity, symes type, expandable wall socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee or knee disarticulation, acrylic socket", "description": "Addition to lower extremity, above knee or knee disarticulation, acrylic socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, symes type, 'ptb' brim design socket", "description": "Addition to lower extremity, symes type, 'ptb' brim design socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, symes type, posterior opening (canadian) socket", "description": "Addition to lower extremity, symes type, posterior opening (canadian) socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5634", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, symes type, medial opening socket", "description": "Addition to lower extremity, symes type, medial opening socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5636", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, total contact", "description": "Addition to lower extremity, below knee, total contact", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, leather socket", "description": "Addition to lower extremity, below knee, leather socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, wood socket", "description": "Addition to lower extremity, below knee, wood socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5639", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, knee disarticulation, leather socket", "description": "Addition to lower extremity, knee disarticulation, leather socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee, leather socket", "description": "Addition to lower extremity, above knee, leather socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, hip disarticulation, flexible inner socket, external frame", "description": "Addition to lower extremity, hip disarticulation, flexible inner socket, external frame", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5643", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee, wood socket", "description": "Addition to lower extremity, above knee, wood socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5644", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, flexible inner socket, external frame", "description": "Addition to lower extremity, below knee, flexible inner socket, external frame", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5645", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket", "description": "Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5646", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee suction socket", "description": "Addition to lower extremity, below knee suction socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5647", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket", "description": "Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5648", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, ischial containment/narrow m-l socket", "description": "Addition to lower extremity, ischial containment/narrow m-l socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5649", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Additions to lower extremity, total contact, above knee or knee disarticulation socket", "description": "Additions to lower extremity, total contact, above knee or knee disarticulation socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee, flexible inner socket, external frame", "description": "Addition to lower extremity, above knee, flexible inner socket, external frame", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5651", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, suction suspension, above knee or knee disarticulation socket", "description": "Addition to lower extremity, suction suspension, above knee or knee disarticulation socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5652", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, knee disarticulation, expandable wall socket", "description": "Addition to lower extremity, knee disarticulation, expandable wall socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5653", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)", "description": "Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5654", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)", "description": "Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5655", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)", "description": "Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5656", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)", "description": "Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5658", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, socket insert, multi-durometer symes", "description": "Addition to lower extremity, socket insert, multi-durometer symes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5661", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, socket insert, multi-durometer, below knee", "description": "Addition to lower extremity, socket insert, multi-durometer, below knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5665", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, cuff suspension", "description": "Addition to lower extremity, below knee, cuff suspension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5666", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, molded distal cushion", "description": "Addition to lower extremity, below knee, molded distal cushion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5668", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)", "description": "Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert", "description": "Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5671", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, removable medial brim suspension", "description": "Addition to lower extremity, below knee, removable medial brim suspension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5672", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism", "description": "Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5673", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Additions to lower extremity, below knee, knee joints, single axis, pair", "description": "Additions to lower extremity, below knee, knee joints, single axis, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5676", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Additions to lower extremity, below knee, knee joints, polycentric, pair", "description": "Additions to lower extremity, below knee, knee joints, polycentric, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5677", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Additions to lower extremity, below knee, joint covers, pair", "description": "Additions to lower extremity, below knee, joint covers, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5678", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism", "description": "Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5679", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, thigh lacer, nonmolded", "description": "Addition to lower extremity, below knee, thigh lacer, nonmolded", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)", "description": "Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5681", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded", "description": "Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5682", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)", "description": "Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5683", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, fork strap", "description": "Addition to lower extremity, below knee, fork strap", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5684", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each", "description": "Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5685", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, back check (extension control)", "description": "Addition to lower extremity, below knee, back check (extension control)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5686", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, waist belt, webbing", "description": "Addition to lower extremity, below knee, waist belt, webbing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5688", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, below knee, waist belt, padded and lined", "description": "Addition to lower extremity, below knee, waist belt, padded and lined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5690", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee, pelvic control belt, light", "description": "Addition to lower extremity, above knee, pelvic control belt, light", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5692", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee, pelvic control belt, padded and lined", "description": "Addition to lower extremity, above knee, pelvic control belt, padded and lined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5694", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each", "description": "Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5695", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee or knee disarticulation, pelvic joint", "description": "Addition to lower extremity, above knee or knee disarticulation, pelvic joint", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5696", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee or knee disarticulation, pelvic band", "description": "Addition to lower extremity, above knee or knee disarticulation, pelvic band", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5697", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity, above knee or knee disarticulation, silesian bandage", "description": "Addition to lower extremity, above knee or knee disarticulation, silesian bandage", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5698", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, shoulder harness", "description": "All lower extremity prostheses, shoulder harness", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement, socket, below knee, molded to patient model", "description": "Replacement, socket, below knee, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model", "description": "Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5701", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement, socket, hip disarticulation, including hip joint, molded to patient model", "description": "Replacement, socket, hip disarticulation, including hip joint, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5702", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only", "description": "Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5703", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Custom shaped protective cover, below knee", "description": "Custom shaped protective cover, below knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5704", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Custom shaped protective cover, above knee", "description": "Custom shaped protective cover, above knee", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5705", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Custom shaped protective cover, knee disarticulation", "description": "Custom shaped protective cover, knee disarticulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5706", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Custom shaped protective cover, hip disarticulation", "description": "Custom shaped protective cover, hip disarticulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5707", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, single axis, manual lock", "description": "Addition, exoskeletal knee-shin system, single axis, manual lock", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material", "description": "Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5711", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)", "description": "Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5712", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control", "description": "Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5714", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock", "description": "Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5716", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control", "description": "Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5718", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control", "description": "Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5722", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, single axis, fluid swing phase control", "description": "Addition, exoskeletal knee-shin system, single axis, fluid swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5724", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control", "description": "Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5726", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control", "description": "Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5728", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control", "description": "Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system", "description": "Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5781", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty", "description": "Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5782", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)", "description": "Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5785", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)", "description": "Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5790", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)", "description": "Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5795", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, single axis, manual lock", "description": "Addition, endoskeletal knee-shin system, single axis, manual lock", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material", "description": "Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5811", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)", "description": "Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5812", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock", "description": "Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5814", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock", "description": "Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5816", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control", "description": "Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5818", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control", "description": "Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5822", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, single axis, fluid swing phase control", "description": "Addition, endoskeletal knee-shin system, single axis, fluid swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5824", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame", "description": "Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5826", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control", "description": "Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5828", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control", "description": "Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5830", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control", "description": "Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5840", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable", "description": "Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5845", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability", "description": "Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5848", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist", "description": "Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5850", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist", "description": "Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5855", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type", "description": "Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5856", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type", "description": "Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5857", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type", "description": "Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5858", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)", "description": "Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5859", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, below knee, alignable system", "description": "Addition, endoskeletal system, below knee, alignable system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, above knee or hip disarticulation, alignable system", "description": "Addition, endoskeletal system, above knee or hip disarticulation, alignable system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5920", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock", "description": "Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5925", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, high activity knee control frame", "description": "Addition, endoskeletal system, high activity knee control frame", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)", "description": "Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)", "description": "Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)", "description": "Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control", "description": "Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5961", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, below knee, flexible protective outer surface covering system", "description": "Addition, endoskeletal system, below knee, flexible protective outer surface covering system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5962", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, above knee, flexible protective outer surface covering system", "description": "Addition, endoskeletal system, above knee, flexible protective outer surface covering system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5964", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system", "description": "Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5966", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature", "description": "Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5968", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)", "description": "Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5969", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, foot, external keel, sach foot", "description": "All lower extremity prostheses, foot, external keel, sach foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only", "description": "All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5971", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, foot, flexible keel", "description": "All lower extremity prostheses, foot, flexible keel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5972", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source", "description": "Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5973", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, foot, single axis ankle/foot", "description": "All lower extremity prostheses, foot, single axis ankle/foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5974", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prosthesis, combination single axis ankle and flexible keel foot", "description": "All lower extremity prosthesis, combination single axis ankle and flexible keel foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5975", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)", "description": "All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5976", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, foot, multiaxial ankle/foot", "description": "All lower extremity prostheses, foot, multiaxial ankle/foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5978", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system", "description": "All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5979", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, flex foot system", "description": "All lower extremity prostheses, flex foot system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, flex-walk system or equal", "description": "All lower extremity prostheses, flex-walk system or equal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5981", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All exoskeletal lower extremity prostheses, axial rotation unit", "description": "All exoskeletal lower extremity prostheses, axial rotation unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability", "description": "All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5984", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All endoskeletal lower extremity prostheses, dynamic prosthetic pylon", "description": "All endoskeletal lower extremity prostheses, dynamic prosthetic pylon", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5985", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal)", "description": "All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5986", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All lower extremity prosthesis, shank foot system with vertical loading pylon", "description": "All lower extremity prosthesis, shank foot system with vertical loading pylon", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5987", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower limb prosthesis, vertical shock reducing pylon feature", "description": "Addition to lower limb prosthesis, vertical shock reducing pylon feature", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5988", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lower extremity prosthesis, user adjustable heel height", "description": "Addition to lower extremity prosthesis, user adjustable heel height", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5990", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lower extremity prosthesis, not otherwise specified", "description": "Lower extremity prosthesis, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L5999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Partial hand, thumb remaining", "description": "Partial hand, thumb remaining", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Partial hand, little and/or ring finger remaining", "description": "Partial hand, little and/or ring finger remaining", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Partial hand, no finger remaining", "description": "Partial hand, no finger remaining", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device", "description": "Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)", "description": "Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad", "description": "Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad", "description": "Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below elbow, molded socket, flexible elbow hinge, triceps pad", "description": "Below elbow, molded socket, flexible elbow hinge, triceps pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below elbow, molded socket, (muenster or northwestern suspension types)", "description": "Below elbow, molded socket, (muenster or northwestern suspension types)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below elbow, molded double wall split socket, step-up hinges, half cuff", "description": "Below elbow, molded double wall split socket, step-up hinges, half cuff", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below elbow, molded double wall split socket, stump activated locking hinge, half cuff", "description": "Below elbow, molded double wall split socket, stump activated locking hinge, half cuff", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow disarticulation, molded socket, outside locking hinge, forearm", "description": "Elbow disarticulation, molded socket, outside locking hinge, forearm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm", "description": "Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above elbow, molded double wall socket, internal locking elbow, forearm", "description": "Above elbow, molded double wall socket, internal locking elbow, forearm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm", "description": "Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder disarticulation, passive restoration (complete prosthesis)", "description": "Shoulder disarticulation, passive restoration (complete prosthesis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder disarticulation, passive restoration (shoulder cap only)", "description": "Shoulder disarticulation, passive restoration (shoulder cap only)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm", "description": "Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interscapular thoracic, passive restoration (complete prosthesis)", "description": "Interscapular thoracic, passive restoration (complete prosthesis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interscapular thoracic, passive restoration (shoulder cap only)", "description": "Interscapular thoracic, passive restoration (shoulder cap only)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow", "description": "Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6380", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow", "description": "Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6382", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic", "description": "Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6384", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, each additional cast change and realignment", "description": "Immediate post surgical or early fitting, each additional cast change and realignment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6386", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Immediate post surgical or early fitting, application of rigid dressing only", "description": "Immediate post surgical or early fitting, application of rigid dressing only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6388", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "description": "Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "description": "Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "description": "Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "description": "Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "description": "Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model", "description": "Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed", "description": "Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6582", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model", "description": "Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6584", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed", "description": "Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6586", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model", "description": "Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6588", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed", "description": "Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity additions, polycentric hinge, pair", "description": "Upper extremity additions, polycentric hinge, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity additions, single pivot hinge, pair", "description": "Upper extremity additions, single pivot hinge, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6605", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity additions, flexible metal hinge, pair", "description": "Upper extremity additions, flexible metal hinge, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, external powered, additional switch, any type", "description": "Addition to upper extremity prosthesis, external powered, additional switch, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6611", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, disconnect locking wrist unit", "description": "Upper extremity addition, disconnect locking wrist unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, additional disconnect insert for locking wrist unit, each", "description": "Upper extremity addition, additional disconnect insert for locking wrist unit, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6616", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, flexion/extension wrist unit, with or without friction", "description": "Upper extremity addition, flexion/extension wrist unit, with or without friction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device", "description": "Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6621", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, spring assisted rotational wrist unit with latch release", "description": "Upper extremity addition, spring assisted rotational wrist unit with latch release", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6623", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, flexion/extension and rotation wrist unit", "description": "Upper extremity addition, flexion/extension and rotation wrist unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, rotation wrist unit with cable lock", "description": "Upper extremity addition, rotation wrist unit with cable lock", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, quick disconnect hook adapter, otto bock or equal", "description": "Upper extremity addition, quick disconnect hook adapter, otto bock or equal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal", "description": "Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, stainless steel, any wrist", "description": "Upper extremity addition, stainless steel, any wrist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, latex suspension sleeve, each", "description": "Upper extremity addition, latex suspension sleeve, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, lift assist for elbow", "description": "Upper extremity addition, lift assist for elbow", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6635", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, nudge control elbow lock", "description": "Upper extremity addition, nudge control elbow lock", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6637", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow", "description": "Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6638", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity additions, shoulder abduction joint, pair", "description": "Upper extremity additions, shoulder abduction joint, pair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6640", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, excursion amplifier, pulley type", "description": "Upper extremity addition, excursion amplifier, pulley type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, excursion amplifier, lever type", "description": "Upper extremity addition, excursion amplifier, lever type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, shoulder flexion-abduction joint, each", "description": "Upper extremity addition, shoulder flexion-abduction joint, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6645", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system", "description": "Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6646", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, shoulder lock mechanism, body powered actuator", "description": "Upper extremity addition, shoulder lock mechanism, body powered actuator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6647", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, shoulder lock mechanism, external powered actuator", "description": "Upper extremity addition, shoulder lock mechanism, external powered actuator", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6648", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, shoulder universal joint, each", "description": "Upper extremity addition, shoulder universal joint, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6650", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, standard control cable, extra", "description": "Upper extremity addition, standard control cable, extra", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6655", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, heavy duty control cable", "description": "Upper extremity addition, heavy duty control cable", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6660", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, teflon, or equal, cable lining", "description": "Upper extremity addition, teflon, or equal, cable lining", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6665", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, hook to hand, cable adapter", "description": "Upper extremity addition, hook to hand, cable adapter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, harness, chest or shoulder, saddle type", "description": "Upper extremity addition, harness, chest or shoulder, saddle type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6672", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, harness, (e.g., figure of eight type), single cable design", "description": "Upper extremity addition, harness, (e.g., figure of eight type), single cable design", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6675", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, harness, (e.g., figure of eight type), dual cable design", "description": "Upper extremity addition, harness, (e.g., figure of eight type), dual cable design", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6676", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow", "description": "Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6677", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, test socket, wrist disarticulation or below elbow", "description": "Upper extremity addition, test socket, wrist disarticulation or below elbow", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, test socket, elbow disarticulation or above elbow", "description": "Upper extremity addition, test socket, elbow disarticulation or above elbow", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6682", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic", "description": "Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6684", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, suction socket", "description": "Upper extremity addition, suction socket", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6686", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, frame type socket, below elbow or wrist disarticulation", "description": "Upper extremity addition, frame type socket, below elbow or wrist disarticulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6687", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, frame type socket, above elbow or elbow disarticulation", "description": "Upper extremity addition, frame type socket, above elbow or elbow disarticulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6688", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, frame type socket, shoulder disarticulation", "description": "Upper extremity addition, frame type socket, shoulder disarticulation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6689", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, frame type socket, interscapular-thoracic", "description": "Upper extremity addition, frame type socket, interscapular-thoracic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6690", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, removable insert, each", "description": "Upper extremity addition, removable insert, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6691", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, silicone gel insert or equal, each", "description": "Upper extremity addition, silicone gel insert or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6692", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity addition, locking elbow, forearm counterbalance", "description": "Upper extremity addition, locking elbow, forearm counterbalance", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6693", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism", "description": "Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6694", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism", "description": "Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6695", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)", "description": "Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6696", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)", "description": "Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6697", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert", "description": "Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6698", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, passive hand/mitt, any material, any size", "description": "Terminal device, passive hand/mitt, any material, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6703", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, sport/recreational/work attachment, any material, any size", "description": "Terminal device, sport/recreational/work attachment, any material, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6704", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined", "description": "Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6706", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined", "description": "Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6707", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hand, mechanical, voluntary opening, any material, any size", "description": "Terminal device, hand, mechanical, voluntary opening, any material, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6708", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hand, mechanical, voluntary closing, any material, any size", "description": "Terminal device, hand, mechanical, voluntary closing, any material, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6709", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric", "description": "Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6711", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric", "description": "Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6712", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric", "description": "Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6713", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric", "description": "Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6714", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement", "description": "Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6715", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined", "description": "Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6721", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined", "description": "Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6722", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to terminal device, modifier wrist unit", "description": "Addition to terminal device, modifier wrist unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6805", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to terminal device, precision pinch device", "description": "Addition to terminal device, precision pinch device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)", "description": "Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6880", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Automatic grasp feature, addition to upper limb electric prosthetic terminal device", "description": "Automatic grasp feature, addition to upper limb electric prosthetic terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6881", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Microprocessor control feature, addition to upper limb prosthetic terminal device", "description": "Microprocessor control feature, addition to upper limb prosthetic terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6882", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power", "description": "Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6883", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power", "description": "Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6884", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power", "description": "Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6885", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment", "description": "Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6890", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated", "description": "Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6895", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining", "description": "Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining", "description": "Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6905", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining", "description": "Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6910", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand restoration (shading, and measurements included), replacement glove for above", "description": "Hand restoration (shading, and measurements included), replacement glove for above", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6915", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device", "description": "Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6920", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "description": "Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6925", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "description": "Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "description": "Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6935", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "description": "Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "description": "Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6945", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "description": "Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "description": "Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6955", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "description": "Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "description": "Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6965", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "description": "Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "description": "Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L6975", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electric hand, switch or myoelectric controlled, adult", "description": "Electric hand, switch or myoelectric controlled, adult", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electric hand, switch or myoelectric, controlled, pediatric", "description": "Electric hand, switch or myoelectric, controlled, pediatric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electric hook, switch or myoelectric controlled, adult", "description": "Electric hook, switch or myoelectric controlled, adult", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prehensile actuator, switch controlled", "description": "Prehensile actuator, switch controlled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electric hook, switch or myoelectric controlled, pediatric", "description": "Electric hook, switch or myoelectric controlled, pediatric", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic elbow, hosmer or equal, switch controlled", "description": "Electronic elbow, hosmer or equal, switch controlled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic elbow, microprocessor sequential control of elbow and terminal device", "description": "Electronic elbow, microprocessor sequential control of elbow and terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic elbow, microprocessor simultaneous control of elbow and terminal device", "description": "Electronic elbow, microprocessor simultaneous control of elbow and terminal device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic elbow, adolescent, variety village or equal, switch controlled", "description": "Electronic elbow, adolescent, variety village or equal, switch controlled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic elbow, child, variety village or equal, switch controlled", "description": "Electronic elbow, child, variety village or equal, switch controlled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic elbow, adolescent, variety village or equal, myoelectronically controlled", "description": "Electronic elbow, adolescent, variety village or equal, myoelectronically controlled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic elbow, child, variety village or equal, myoelectronically controlled", "description": "Electronic elbow, child, variety village or equal, myoelectronically controlled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7191", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic wrist rotator, any type", "description": "Electronic wrist rotator, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7259", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic wrist rotator, otto bock or equal", "description": "Electronic wrist rotator, otto bock or equal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic wrist rotator, for utah arm", "description": "Electronic wrist rotator, for utah arm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7261", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Six volt battery, each", "description": "Six volt battery, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery charger, six volt, each", "description": "Battery charger, six volt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7362", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Twelve volt battery, each", "description": "Twelve volt battery, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery charger, twelve volt, each", "description": "Battery charger, twelve volt, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7366", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lithium ion battery, rechargeable, replacement", "description": "Lithium ion battery, rechargeable, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7367", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lithium ion battery charger, replacement only", "description": "Lithium ion battery charger, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7368", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)", "description": "Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)", "description": "Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7401", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)", "description": "Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7402", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material", "description": "Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7403", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material", "description": "Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7404", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material", "description": "Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7405", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper extremity prosthesis, not otherwise specified", "description": "Upper extremity prosthesis, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair of prosthetic device, repair or replace minor parts", "description": "Repair of prosthetic device, repair or replace minor parts", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair prosthetic device, labor component, per 15 minutes", "description": "Repair prosthetic device, labor component, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic donning sleeve, any material, each", "description": "Prosthetic donning sleeve, any material, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gasket or seal, for use with prosthetic socket insert, any type, each", "description": "Gasket or seal, for use with prosthetic socket insert, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Male vacuum erection system", "description": "Male vacuum erection system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tension ring, for vacuum erection device, any type, replacement only, each", "description": "Tension ring, for vacuum erection device, any type, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L7902", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type", "description": "Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type", "description": "Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type", "description": "Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast prosthesis, mastectomy sleeve", "description": "Breast prosthesis, mastectomy sleeve", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External breast prosthesis garment, with mastectomy form, post mastectomy", "description": "External breast prosthesis garment, with mastectomy form, post mastectomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast prosthesis, mastectomy form", "description": "Breast prosthesis, mastectomy form", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast prosthesis, silicone or equal, without integral adhesive", "description": "Breast prosthesis, silicone or equal, without integral adhesive", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast prosthesis, silicone or equal, with integral adhesive", "description": "Breast prosthesis, silicone or equal, with integral adhesive", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nipple prosthesis, prefabricated, reusable, any type, each", "description": "Nipple prosthesis, prefabricated, reusable, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nipple prosthesis, custom fabricated, reusable, any material, any type, each", "description": "Nipple prosthesis, custom fabricated, reusable, any material, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Custom breast prosthesis, post mastectomy, molded to patient model", "description": "Custom breast prosthesis, post mastectomy, molded to patient model", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast prosthesis, not otherwise specified", "description": "Breast prosthesis, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasal prosthesis, provided by a non-physician", "description": "Nasal prosthesis, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Midfacial prosthesis, provided by a non-physician", "description": "Midfacial prosthesis, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orbital prosthesis, provided by a non-physician", "description": "Orbital prosthesis, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Upper facial prosthesis, provided by a non-physician", "description": "Upper facial prosthesis, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hemi-facial prosthesis, provided by a non-physician", "description": "Hemi-facial prosthesis, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Auricular prosthesis, provided by a non-physician", "description": "Auricular prosthesis, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Partial facial prosthesis, provided by a non-physician", "description": "Partial facial prosthesis, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasal septal prosthesis, provided by a non-physician", "description": "Nasal septal prosthesis, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unspecified maxillofacial prosthesis, by report, provided by a non-physician", "description": "Unspecified maxillofacial prosthesis, by report, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8048", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician", "description": "Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8049", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Truss, single with standard pad", "description": "Truss, single with standard pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Truss, double with standard pads", "description": "Truss, double with standard pads", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Truss, addition to standard pad, water pad", "description": "Truss, addition to standard pad, water pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Truss, addition to standard pad, scrotal pad", "description": "Truss, addition to standard pad, scrotal pad", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sheath, below knee, each", "description": "Prosthetic sheath, below knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sheath, above knee, each", "description": "Prosthetic sheath, above knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sheath, upper limb, each", "description": "Prosthetic sheath, upper limb, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8415", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each", "description": "Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8417", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sock, multiple ply, below knee, each", "description": "Prosthetic sock, multiple ply, below knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sock, multiple ply, above knee, each", "description": "Prosthetic sock, multiple ply, above knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sock, multiple ply, upper limb, each", "description": "Prosthetic sock, multiple ply, upper limb, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8435", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic shrinker, below knee, each", "description": "Prosthetic shrinker, below knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8440", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic shrinker, above knee, each", "description": "Prosthetic shrinker, above knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic shrinker, upper limb, each", "description": "Prosthetic shrinker, upper limb, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sock, single ply, fitting, below knee, each", "description": "Prosthetic sock, single ply, fitting, below knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sock, single ply, fitting, above knee, each", "description": "Prosthetic sock, single ply, fitting, above knee, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic sock, single ply, fitting, upper limb, each", "description": "Prosthetic sock, single ply, fitting, upper limb, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unlisted procedure for miscellaneous prosthetic services", "description": "Unlisted procedure for miscellaneous prosthetic services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artificial larynx, any type", "description": "Artificial larynx, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy speaking valve", "description": "Tracheostomy speaking valve", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artificial larynx replacement battery / accessory, any type", "description": "Artificial larynx replacement battery / accessory, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheo-esophageal voice prosthesis, patient inserted, any type, each", "description": "Tracheo-esophageal voice prosthesis, patient inserted, any type, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type", "description": "Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Voice amplifier", "description": "Voice amplifier", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each", "description": "Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8511", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10", "description": "Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each", "description": "Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheoesophageal puncture dilator, replacement only, each", "description": "Tracheoesophageal puncture dilator, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8514", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each", "description": "Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable breast prosthesis, silicone or equal", "description": "Implantable breast prosthesis, silicone or equal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies", "description": "Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8603", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies", "description": "Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies", "description": "Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8605", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies", "description": "Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8606", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies", "description": "Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8607", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system", "description": "Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8608", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artificial cornea", "description": "Artificial cornea", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8609", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ocular implant", "description": "Ocular implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aqueous shunt", "description": "Aqueous shunt", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8612", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ossicula implant", "description": "Ossicula implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8613", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cochlear device, includes all internal and external components", "description": "Cochlear device, includes all internal and external components", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8614", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Headset/headpiece for use with cochlear implant device, replacement", "description": "Headset/headpiece for use with cochlear implant device, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Microphone for use with cochlear implant device, replacement", "description": "Microphone for use with cochlear implant device, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8616", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transmitting coil for use with cochlear implant device, replacement", "description": "Transmitting coil for use with cochlear implant device, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8617", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement", "description": "Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8618", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cochlear implant, external speech processor and controller, integrated system, replacement", "description": "Cochlear implant, external speech processor and controller, integrated system, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8619", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each", "description": "Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8621", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alkaline battery for use with cochlear implant device, any size, replacement, each", "description": "Alkaline battery for use with cochlear implant device, any size, replacement, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each", "description": "Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8623", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each", "description": "Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each", "description": "External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cochlear implant, external speech processor, component, replacement", "description": "Cochlear implant, external speech processor, component, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cochlear implant, external controller component, replacement", "description": "Cochlear implant, external controller component, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transmitting coil and cable, integrated, for use with cochlear implant device, replacement", "description": "Transmitting coil and cable, integrated, for use with cochlear implant device, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metacarpophalangeal joint implant", "description": "Metacarpophalangeal joint implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)", "description": "Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metatarsal joint implant", "description": "Metatarsal joint implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8641", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hallux implant", "description": "Hallux implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8642", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interphalangeal joint spacer, silicone or equal, each", "description": "Interphalangeal joint spacer, silicone or equal, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8658", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size", "description": "Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8659", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vascular graft material, synthetic, implant", "description": "Vascular graft material, synthetic, implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8670", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable neurostimulator, pulse generator, any type", "description": "Implantable neurostimulator, pulse generator, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8679", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable neurostimulator electrode, each", "description": "Implantable neurostimulator electrode, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8680", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only", "description": "Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8681", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable neurostimulator radiofrequency receiver", "description": "Implantable neurostimulator radiofrequency receiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8682", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver", "description": "Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8683", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement", "description": "Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8684", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable neurostimulator pulse generator, single array, rechargeable, includes extension", "description": "Implantable neurostimulator pulse generator, single array, rechargeable, includes extension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8685", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension", "description": "Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8686", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension", "description": "Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8687", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension", "description": "Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8688", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External recharging system for battery (internal) for use with implantable neurostimulator, replacement only", "description": "External recharging system for battery (internal) for use with implantable neurostimulator, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8689", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Auditory osseointegrated device, includes all internal and external components", "description": "Auditory osseointegrated device, includes all internal and external components", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8690", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each", "description": "Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8691", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment", "description": "Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8692", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Auditory osseointegrated device abutment, any length, replacement only", "description": "Auditory osseointegrated device abutment, any length, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8693", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Auditory osseointegrated device, transducer/actuator, replacement only, each", "description": "Auditory osseointegrated device, transducer/actuator, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8694", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "External recharging system for battery (external) for use with implantable neurostimulator, replacement only", "description": "External recharging system for battery (external) for use with implantable neurostimulator, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8695", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each", "description": "Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8696", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous component, supply or accessory for use with total artificial heart system", "description": "Miscellaneous component, supply or accessory for use with total artificial heart system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8698", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic implant, not otherwise specified", "description": "Prosthetic implant, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8699", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated", "description": "Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8701", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated", "description": "Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L8702", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs \"l\" code", "description": "Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs \"l\" code", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "L9900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders", "description": "Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0064", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cellular therapy", "description": "Cellular therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0075", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prolotherapy", "description": "Prolotherapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0076", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intragastric hypothermia using gastric freezing", "description": "Intragastric hypothermia using gastric freezing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home", "description": "Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring", "description": "Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0239", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat doses", "description": "Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat doses", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency, subsequent repeat doses", "description": "Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency, subsequent repeat doses", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0241", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring", "description": "Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0243", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency", "description": "Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0244", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring", "description": "Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider based to the hospital during the covid 19 public health emergency", "description": "Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider based to the hospital during the covid 19 public health emergency", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion, sotrovimab, includes infusion and post administration monitoring", "description": "Intravenous infusion, sotrovimab, includes infusion and post administration monitoring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency", "description": "Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose", "description": "Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0249", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose", "description": "Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iv chelation therapy (chemical endarterectomy)", "description": "Iv chelation therapy (chemical endarterectomy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fabric wrapping of abdominal aneurysm", "description": "Fabric wrapping of abdominal aneurysm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M0301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pain screened as moderate to severe", "description": "Pain screened as moderate to severe", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician", "description": "Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given", "description": "Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic disease modifying anti-rheumatic drug therapy", "description": "Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic disease modifying anti-rheumatic drug therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of medical reason for not screening for tb or interpreting results (i.e., patient positive for tb and documentation of past treatment; patient who has recently completed a course of anti-tb therapy)", "description": "Documentation of medical reason for not screening for tb or interpreting results (i.e., patient positive for tb and documentation of past treatment; patient who has recently completed a course of anti-tb therapy)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tb screening not performed or results not interpreted, reason not given", "description": "Tb screening not performed or results not interpreted, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disease activity not assessed, reason not given", "description": "Disease activity not assessed, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": ">=50% of total number of a patient's outpatient ra encounters assessed", "description": ">=50% of total number of a patient's outpatient ra encounters assessed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "<50% of total number of a patient's outpatient ra encounters assessed", "description": "<50% of total number of a patient's outpatient ra encounters assessed", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Discharge/discontinuation of the episode of care documented in the medical record", "description": "Discharge/discontinuation of the episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Discharge/discontinuation of the episode of care documented in the medical record", "description": "Discharge/discontinuation of the episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Discharge/discontinuation of the episode of care documented in the medical record", "description": "Discharge/discontinuation of the episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Discharge/discontinuation of the episode of care documented in the medical record", "description": "Discharge/discontinuation of the episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Discharge/discontinuation of the episode of care documented in the medical record", "description": "Discharge/discontinuation of the episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Discharge/discontinuation of the episode of care documented in the medical record", "description": "Discharge/discontinuation of the episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Discharge/discontinuation of the episode of care documented in the medical record", "description": "Discharge/discontinuation of the episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Female patients unable to bear children", "description": "Female patients unable to bear children", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient admitted to palliative care services", "description": "Patient admitted to palliative care services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients", "description": "Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5", "description": "Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5", "description": "Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had only urgent care visits during the performance period", "description": "Patient had only urgent care visits during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who were in hospice at any time during the performance period", "description": "Patients who were in hospice at any time during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five", "description": "Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five. either phq-9 or phq-9m score was not assessed or is greater than or equal to five", "description": "Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five. either phq-9 or phq-9m score was not assessed or is greater than or equal to five", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who were in hospice at any time during the performance period", "description": "Patients who were in hospice at any time during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients who were in hospice at any time during the performance period", "description": "Patients who were in hospice at any time during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Imaging of the head (ct or mri) was obtained", "description": "Imaging of the head (ct or mri) was obtained", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained", "description": "Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Imaging of the head (ct or mri) was not obtained, reason not given", "description": "Imaging of the head (ct or mri) was not obtained, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with clinical indications for imaging of the head", "description": "Patients with clinical indications for imaging of the head", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with no clinical indications for imaging of the head", "description": "Patients with no clinical indications for imaging of the head", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adults currently taking pharmacotherapy for oud", "description": "Adults currently taking pharmacotherapy for oud", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacotherapy for oud initiated after june 30th of performance period", "description": "Pharmacotherapy for oud initiated after june 30th of performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days", "description": "Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment", "description": "Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days", "description": "Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with a diagnosis of lumbar spine region cancer at the time of the procedure", "description": "Patients with a diagnosis of lumbar spine region cancer at the time of the procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with a diagnosis of lumbar spine region fracture at the time of the procedure", "description": "Patients with a diagnosis of lumbar spine region fracture at the time of the procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with a diagnosis of lumbar spine region infection at the time of the procedure", "description": "Patients with a diagnosis of lumbar spine region infection at the time of the procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients with a diagnosis of lumbar idiopathic or congenital scoliosis", "description": "Patients with a diagnosis of lumbar idiopathic or congenital scoliosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis", "description": "Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively", "description": "Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively", "description": "Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively", "description": "Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was greater than or equal to 37 or knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was greater than or equal to 71", "description": "Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was greater than or equal to 37 or knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was greater than or equal to 71", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively", "description": "Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status was measured by the oxford knee score (oks) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively", "description": "Functional status was measured by the oxford knee score (oks) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively", "description": "Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1048", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status was not measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively", "description": "Functional status was not measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1049", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively", "description": "Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis", "description": "Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1051", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg pain was not measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively", "description": "Leg pain was not measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively", "description": "Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1053", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had only urgent care visits during the performance period", "description": "Patient had only urgent care visits during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1054", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aspirin or another antiplatelet therapy used", "description": "Aspirin or another antiplatelet therapy used", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease", "description": "Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1056", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aspirin or another antiplatelet therapy not used, reason not given", "description": "Aspirin or another antiplatelet therapy not used, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1057", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was a permanent nursing home resident at any time during the performance period", "description": "Patient was a permanent nursing home resident at any time during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1058", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient was in hospice or receiving palliative care at any time during the performance period", "description": "Patient was in hospice or receiving palliative care at any time during the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1059", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient died prior to the end of the performance period", "description": "Patient died prior to the end of the performance period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient pregnancy", "description": "Patient pregnancy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1061", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient immunocompromised", "description": "Patient immunocompromised", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1062", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patients receiving high doses of immunosuppressive therapy", "description": "Patients receiving high doses of immunosuppressive therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1063", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shingrix vaccine documented as administered or previously received", "description": "Shingrix vaccine documented as administered or previously received", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1064", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)", "description": "Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1065", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shingrix vaccine not documented as administered, reason not given", "description": "Shingrix vaccine not documented as administered, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1066", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice services for patient provided any time during the measurement period", "description": "Hospice services for patient provided any time during the measurement period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1067", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adults who are not ambulatory", "description": "Adults who are not ambulatory", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1068", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient screened for future fall risk", "description": "Patient screened for future fall risk", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1069", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient not screened for future fall risk, reason not given", "description": "Patient not screened for future fall risk, reason not given", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy", "description": "Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", 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"service_code": [ "11" ] } ] } ] }, { "name": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "description": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1107", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not clinically indicated because the patient needed a home program only, referral to 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"Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1109", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "description": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason 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charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "description": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not 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"Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record", "description": "Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1123", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery", "description": "Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1124", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "description": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1125", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "The start of an episode of care documented in the medical record", "description": "The start of an episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "description": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1127", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", 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"billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery", "description": "Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1129", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "description": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "description": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record", "description": "Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or 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"negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1133", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "description": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1134", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "The start of an episode of care documented in the medical record", "description": "The start of an episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1135", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "The start of an episode of care documented in the medical record", "description": "The start of an episode of care documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1136", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "description": "Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1137", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)", "description": "Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1138", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "description": "Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1139", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery for surgery or hospitalized", "description": "Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery for surgery or hospitalized", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Functional status was not measured by the oxford knee score (oks) or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) at one year (9 to 15 months) postoperatively", "description": "Functional status was not measured by the oxford knee score (oks) or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) at one year (9 to 15 months) postoperatively", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1141", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergent cases", "description": "Emergent cases", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1142", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment", "description": "Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1143", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only", "description": "Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1144", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier)", "description": "Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record", "description": "Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1146", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery", "description": "Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1147", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "description": "Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1148", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility, and an adequate proxy is not available", "description": "Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility, and an adequate proxy is not available", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "M1149", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cephalin floculation, blood", "description": "Cephalin floculation, blood", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P2028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Congo red, blood", "description": "Congo red, blood", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P2029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hair analysis (excluding arsenic)", "description": "Hair analysis (excluding arsenic)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P2031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Thymol turbidity, blood", "description": "Thymol turbidity, blood", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P2033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mucoprotein, blood (seromucoid) (medical necessity procedure)", "description": "Mucoprotein, blood (seromucoid) (medical necessity procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P2038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision", "description": "Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P3000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician", "description": "Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P3001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Culture, bacterial, urine; quantitative, sensitivity study", "description": "Culture, bacterial, urine; quantitative, sensitivity study", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P7001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood (whole), for transfusion, per unit", "description": "Blood (whole), for transfusion, per unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood, split unit", "description": "Blood, split unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cryoprecipitate, each unit", "description": "Cryoprecipitate, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Red blood cells, leukocytes reduced, each unit", "description": "Red blood cells, leukocytes reduced, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit", "description": "Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, each unit", "description": "Platelets, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelet rich plasma, each unit", "description": "Platelet rich plasma, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Red blood cells, each unit", "description": "Red blood cells, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Red blood cells, washed, each unit", "description": "Red blood cells, washed, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit", "description": "Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plasma, cryoprecipitate reduced, pathogen reduced, each unit", "description": "Plasma, cryoprecipitate reduced, pathogen reduced, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cryoprecipitated fibrinogen complex, pathogen reduced, each unit", "description": "Cryoprecipitated fibrinogen complex, pathogen reduced, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, leukocytes reduced, each unit", "description": "Platelets, leukocytes reduced, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, irradiated, each unit", "description": "Platelets, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, leukocytes reduced, irradiated, each unit", "description": "Platelets, leukocytes reduced, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, pheresis, each unit", "description": "Platelets, pheresis, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, pheresis, leukocytes reduced, each unit", "description": "Platelets, pheresis, leukocytes reduced, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, pheresis, irradiated, each unit", "description": "Platelets, pheresis, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, pheresis, leukocytes reduced, irradiated, each unit", "description": "Platelets, pheresis, leukocytes reduced, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Red blood cells, irradiated, each unit", "description": "Red blood cells, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Red blood cells, deglycerolized, each unit", "description": "Red blood cells, deglycerolized, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Red blood cells, leukocytes reduced, irradiated, each unit", "description": "Red blood cells, leukocytes reduced, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, albumin (human), 5%, 50 ml", "description": "Infusion, albumin (human), 5%, 50 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, plasma protein fraction (human), 5%, 50 ml", "description": "Infusion, plasma protein fraction (human), 5%, 50 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plasma, cryoprecipitate reduced, each unit", "description": "Plasma, cryoprecipitate reduced, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, albumin (human), 5%, 250 ml", "description": "Infusion, albumin (human), 5%, 250 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, albumin (human), 25%, 20 ml", "description": "Infusion, albumin (human), 25%, 20 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, albumin (human), 25%, 50 ml", "description": "Infusion, albumin (human), 25%, 50 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion, plasma protein fraction (human), 5%, 250 ml", "description": "Infusion, plasma protein fraction (human), 5%, 250 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9048", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Granulocytes, pheresis, each unit", "description": "Granulocytes, pheresis, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Whole blood or red blood cells, leukocytes reduced, cmv-negative, each unit", "description": "Whole blood or red blood cells, leukocytes reduced, cmv-negative, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9051", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit", "description": "Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit", "description": "Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9053", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Whole blood or red blood cells, leukocytes reduced, frozen, deglycerol, washed, each unit", "description": "Whole blood or red blood cells, leukocytes reduced, frozen, deglycerol, washed, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9054", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit", "description": "Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Whole blood, leukocytes reduced, irradiated, each unit", "description": "Whole blood, leukocytes reduced, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9056", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Red blood cells, frozen/deglycerolized/washed, leukocytes reduced, irradiated, each unit", "description": "Red blood cells, frozen/deglycerolized/washed, leukocytes reduced, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9057", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit", "description": "Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9058", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fresh frozen plasma between 8-24 hours of collection, each unit", "description": "Fresh frozen plasma between 8-24 hours of collection, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9059", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fresh frozen plasma, donor retested, each unit", "description": "Fresh frozen plasma, donor retested, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plasma, pooled multiple donor, pathogen reduced, frozen, each unit", "description": "Plasma, pooled multiple donor, pathogen reduced, frozen, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Plasma (single donor), pathogen reduced, frozen, each unit", "description": "Plasma (single donor), pathogen reduced, frozen, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9071", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, pheresis, pathogen reduced or rapid bacterial tested, each unit", "description": "Platelets, pheresis, pathogen reduced or rapid bacterial tested, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9072", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, pheresis, pathogen-reduced, each unit", "description": "Platelets, pheresis, pathogen-reduced, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9073", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Blood component or product not otherwise classified", "description": "Blood component or product not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9099", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathogen(s) test for platelets", "description": "Pathogen(s) test for platelets", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled", "description": "Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9603", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge", "description": "Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9604", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheterization for collection of specimen, single patient, all places of service", "description": "Catheterization for collection of specimen, single patient, all places of service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9612", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Catheterization for collection of specimen(s) (multiple patients)", "description": "Catheterization for collection of specimen(s) (multiple patients)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "P9615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiokymography", "description": "Cardiokymography", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infusion therapy, using other than chemotherapeutic drugs, per visit", "description": "Infusion therapy, using other than chemotherapeutic drugs, per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0081", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit", "description": "Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chemotherapy administration by infusion technique only, per visit", "description": "Chemotherapy administration by infusion technique only, per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0084", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit", "description": "Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0085", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory", "description": "Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0091", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Set-up portable x-ray equipment", "description": "Set-up portable x-ray equipment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0092", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wet mounts, including preparations of vaginal, cervical or skin specimens", "description": "Wet mounts, including preparations of vaginal, cervical or skin specimens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0111", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "All potassium hydroxide (koh) preparations", "description": "All potassium hydroxide (koh) preparations", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pinworm examinations", "description": "Pinworm examinations", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fern test", "description": "Fern test", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0114", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Post-coital direct, qualitative examinations of vaginal or cervical mucous", "description": "Post-coital direct, qualitative examinations of vaginal or cervical mucous", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0115", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)", "description": "Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0138", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)", "description": "Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0139", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Azithromycin dihydrate, oral, capsules/powder, 1 gram", "description": "Azithromycin dihydrate, oral, capsules/powder, 1 gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0144", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen", "description": "Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0163", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0164", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen", "description": "Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0166", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0167", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0169", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0173", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0174", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0177", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen", "description": "Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "description": "Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bamlanivimab-xxxx, 700 mg", "description": "Injection, bamlanivimab-xxxx, 700 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0239", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, casirivimab and imdevimab, 600 mg", "description": "Injection, casirivimab and imdevimab, 600 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, casirivimab and imdevimab, 2400 mg", "description": "Injection, casirivimab and imdevimab, 2400 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0243", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, casirivimab and imdevimab, 1200 mg", "description": "Injection, casirivimab and imdevimab, 1200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0244", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bamlanivimab and etesevimab, 2100 mg", "description": "Injection, bamlanivimab and etesevimab, 2100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sotrovimab, 500 mg", "description": "Injection, sotrovimab, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg", "description": "Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0249", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0477", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type", "description": "Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0478", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power module for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Power module for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0479", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Driver for use with pneumatic ventricular assist device, replacement only", "description": "Driver for use with pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Microprocessor control unit for use with electric ventricular assist device, replacement only", "description": "Microprocessor control unit for use with electric ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0481", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only", "description": "Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0482", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Monitor/display module for use with electric ventricular assist device, replacement only", "description": "Monitor/display module for use with electric ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0483", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0484", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Monitor control cable for use with electric ventricular assist device, replacement only", "description": "Monitor control cable for use with electric ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only", "description": "Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0486", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only", "description": "Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0487", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power pack base for use with electric ventricular assist device, replacement only", "description": "Power pack base for use with electric ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0488", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power pack base for use with electric/pneumatic ventricular assist device, replacement only", "description": "Power pack base for use with electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0489", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency power source for use with electric ventricular assist device, replacement only", "description": "Emergency power source for use with electric ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency power source for use with electric/pneumatic ventricular assist device, replacement only", "description": "Emergency power source for use with electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0491", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency power supply cable for use with electric ventricular assist device, replacement only", "description": "Emergency power supply cable for use with electric ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0492", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only", "description": "Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0493", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0494", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0495", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0496", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0497", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Holster for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Holster for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0498", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only", "description": "Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Filters for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Filters for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mobility cart for pneumatic ventricular assist device, replacement only", "description": "Mobility cart for pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery for pneumatic ventricular assist device, replacement only, each", "description": "Battery for pneumatic ventricular assist device, replacement only, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Power adapter for pneumatic ventricular assist device, replacement only, vehicle type", "description": "Power adapter for pneumatic ventricular assist device, replacement only, vehicle type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only", "description": "Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous supply or accessory for use with an external ventricular assist device", "description": "Miscellaneous supply or accessory for use with an external ventricular assist device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0507", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous supply or accessory for use with an implanted ventricular assist device", "description": "Miscellaneous supply or accessory for use with an implanted ventricular assist device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a", "description": "Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0509", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant", "description": "Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period", "description": "Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0511", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period", "description": "Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacy dispensing fee for inhalation drug(s); per 30 days", "description": "Pharmacy dispensing fee for inhalation drug(s); per 30 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacy dispensing fee for inhalation drug(s); per 90 days", "description": "Pharmacy dispensing fee for inhalation drug(s); per 90 days", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0514", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sermorelin acetate, 1 microgram", "description": "Injection, sermorelin acetate, 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q0515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "New technology intraocular lens category 4 as defined in federal register notice", "description": "New technology intraocular lens category 4 as defined in federal register notice", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q1004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "New technology intraocular lens category 5 as defined in federal register notice", "description": "New technology intraocular lens category 5 as defined in federal register notice", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q1005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml", "description": "Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fosphenytoin, 50 mg phenytoin equivalent", "description": "Injection, fosphenytoin, 50 mg phenytoin equivalent", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, teniposide, 50 mg", "description": "Injection, teniposide, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, radiesse, 0.1 ml", "description": "Injection, radiesse, 0.1 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sculptra, 0.5 mg", "description": "Injection, sculptra, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza virus vaccine, split virus, for intramuscular use (agriflu)", "description": "Influenza virus vaccine, split virus, for intramuscular use (agriflu)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)", "description": "Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval)", "description": "Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)", "description": "Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)", "description": "Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Influenza virus vaccine, not otherwise specified", "description": "Influenza virus vaccine, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion", "description": "Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "description": "Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "description": "Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion", "description": "Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg", "description": "Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2049", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg", "description": "Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration", "description": "Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q2052", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic 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"provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, long leg cast, pediatric (0-10 years), fiberglass", "description": "Cast supplies, long leg cast, pediatric (0-10 years), fiberglass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, long leg cylinder cast, 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"negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster", "description": "Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass", "description": "Cast supplies, long leg cylinder 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{100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, short leg cast, adult (11 years +), fiberglass", "description": "Cast supplies, short leg cast, adult (11 years +), fiberglass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, short leg cast, pediatric (0-10 years), plaster", "description": "Cast supplies, short leg cast, pediatric (0-10 years), plaster", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": 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] }, { "name": "Cast supplies, long leg splint, adult (11 years +), plaster", "description": "Cast supplies, long leg splint, adult (11 years +), plaster", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, long leg splint, adult (11 years +), fiberglass", "description": "Cast supplies, long leg splint, adult (11 years +), fiberglass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, long leg splint, pediatric (0-10 years), plaster", "description": "Cast supplies, long leg splint, pediatric (0-10 years), plaster", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, long leg splint, pediatric (0-10 years), fiberglass", "description": "Cast supplies, long leg splint, pediatric (0-10 years), fiberglass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, short leg splint, adult (11 years +), plaster", "description": "Cast supplies, short leg splint, adult (11 years +), plaster", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, short leg splint, adult (11 years +), fiberglass", "description": "Cast supplies, short leg splint, adult (11 years +), fiberglass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, short leg splint, pediatric (0-10 years), plaster", "description": "Cast supplies, short leg splint, pediatric (0-10 years), plaster", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, short leg splint, pediatric (0-10 years), fiberglass", "description": "Cast supplies, short leg splint, pediatric (0-10 years), fiberglass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4048", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Finger splint, static", "description": "Finger splint, static", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4049", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cast supplies, for unlisted types and materials of casts", "description": "Cast supplies, for unlisted types and materials of casts", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)", "description": "Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4051", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms", "description": "Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4074", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin alfa, 100 units (for esrd on dialysis)", "description": "Injection, epoetin alfa, 100 units (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4081", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Drug or biological, not otherwise classified, part b drug competitive acquisition program (cap)", "description": "Drug or biological, not otherwise classified, part b drug competitive acquisition program (cap)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4082", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin substitute, not otherwise specified", "description": "Skin substitute, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Apligraf, per square centimeter", "description": "Apligraf, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oasis wound matrix, per square centimeter", "description": "Oasis wound matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oasis burn matrix, per square centimeter", "description": "Oasis burn matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4103", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Integra bilayer matrix wound dressing (bmwd), per square centimeter", "description": "Integra bilayer matrix wound dressing (bmwd), per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4104", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter", "description": "Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermagraft, per square centimeter", "description": "Dermagraft, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4106", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Graftjacket, per square centimeter", "description": "Graftjacket, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4107", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Integra matrix, per square centimeter", "description": "Integra matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4108", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Primatrix, per square centimeter", "description": "Primatrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gammagraft, per square centimeter", "description": "Gammagraft, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4111", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cymetra, injectable, 1 cc", "description": "Cymetra, injectable, 1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Graftjacket xpress, injectable, 1 cc", "description": "Graftjacket xpress, injectable, 1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Integra flowable wound matrix, injectable, 1 cc", "description": "Integra flowable wound matrix, injectable, 1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4114", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alloskin, per square centimeter", "description": "Alloskin, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4115", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alloderm, per square centimeter", "description": "Alloderm, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4116", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyalomatrix, per square centimeter", "description": "Hyalomatrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Matristem micromatrix, 1 mg", "description": "Matristem micromatrix, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4118", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Matristem wound matrix, per square centimeter", "description": "Matristem wound matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4119", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Matristem burn matrix, per square centimeter", "description": "Matristem burn matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Theraskin, per square centimeter", "description": "Theraskin, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermacell, dermacell awm or dermacell awm porous, per square centimeter", "description": "Dermacell, dermacell awm or dermacell awm porous, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alloskin rt, per square centimeter", "description": "Alloskin rt, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4123", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oasis ultra tri-layer wound matrix, per square centimeter", "description": "Oasis ultra tri-layer wound matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4124", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Arthroflex, per square centimeter", "description": "Arthroflex, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4125", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Memoderm, dermaspan, tranzgraft or integuply, per square centimeter", "description": "Memoderm, dermaspan, tranzgraft or integuply, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Talymed, per square centimeter", "description": "Talymed, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4127", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Flex hd, allopatch hd, or matrix hd, per square centimeter", "description": "Flex hd, allopatch hd, or matrix hd, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4128", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unite biomatrix, per square centimeter", "description": "Unite biomatrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4129", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Strattice tm, per square centimeter", "description": "Strattice tm, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Epifix or epicord, per square centimeter", "description": "Epifix or epicord, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Grafix core and grafixpl core, per square centimeter", "description": "Grafix core and grafixpl core, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4132", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter", "description": "Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4133", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hmatrix, per square centimeter", "description": "Hmatrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4134", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mediskin, per square centimeter", "description": "Mediskin, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4135", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ez-derm, per square centimeter", "description": "Ez-derm, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4136", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amnioexcel, amnioexcel plus or biodexcel, per square centimeter", "description": "Amnioexcel, amnioexcel plus or biodexcel, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4137", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Biodfence dryflex, per square centimeter", "description": "Biodfence dryflex, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4138", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniomatrix or biodmatrix, injectable, 1 cc", "description": "Amniomatrix or biodmatrix, injectable, 1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4139", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Biodfence, per square centimeter", "description": "Biodfence, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alloskin ac, per square centimeter", "description": "Alloskin ac, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4141", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Xcm biologic tissue matrix, per square centimeter", "description": "Xcm biologic tissue matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4142", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repriza, per square centimeter", "description": "Repriza, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4143", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Epifix, injectable, 1 mg", "description": "Epifix, injectable, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tensix, per square centimeter", "description": "Tensix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4146", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Architect, architect px, or architect fx, extracellular matrix, per square centimeter", "description": "Architect, architect px, or architect fx, extracellular matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4147", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter", "description": "Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4148", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Excellagen, 0.1 cc", "description": "Excellagen, 0.1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4149", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Allowrap ds or dry, per square centimeter", "description": "Allowrap ds or dry, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amnioband or guardian, per square centimeter", "description": "Amnioband or guardian, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4151", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermapure, per square centimeter", "description": "Dermapure, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4152", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermavest and plurivest, per square centimeter", "description": "Dermavest and plurivest, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4153", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Biovance, per square centimeter", "description": "Biovance, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4154", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Neoxflo or clarixflo, 1 mg", "description": "Neoxflo or clarixflo, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4155", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Neox 100 or clarix 100, per square centimeter", "description": "Neox 100 or clarix 100, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4156", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revitalon, per square centimeter", "description": "Revitalon, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4157", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Kerecis omega3, per square centimeter", "description": "Kerecis omega3, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4158", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Affinity, per square centimeter", "description": "Affinity, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4159", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nushield, per square centimeter", "description": "Nushield, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bio-connekt wound matrix, per square centimeter", "description": "Bio-connekt wound matrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Woundex flow, bioskin flow, 0.5 cc", "description": "Woundex flow, bioskin flow, 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Woundex, bioskin, per square centimeter", "description": "Woundex, bioskin, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4163", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Helicoll, per square centimeter", "description": "Helicoll, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4164", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Keramatrix or kerasorb, per square centimeter", "description": "Keramatrix or kerasorb, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4165", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cytal, per square centimeter", "description": "Cytal, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4166", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Truskin, per square centimeter", "description": "Truskin, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4167", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amnioband, 1 mg", "description": "Amnioband, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4168", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artacent wound, per square centimeter", "description": "Artacent wound, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4169", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cygnus, per square centimeter", "description": "Cygnus, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interfyl, 1 mg", "description": "Interfyl, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Puraply or puraply am, per square centimeter", "description": "Puraply or puraply am, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4172", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Palingen or palingen xplus, per square centimeter", "description": "Palingen or palingen xplus, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4173", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Palingen or promatrx, 0.36 mg per 0.25 cc", "description": "Palingen or promatrx, 0.36 mg per 0.25 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4174", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miroderm, per square centimeter", "description": "Miroderm, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Neopatch or therion, per square centimeter", "description": "Neopatch or therion, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4176", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Floweramnioflo, 0.1 cc", "description": "Floweramnioflo, 0.1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4177", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Floweramniopatch, per square centimeter", "description": "Floweramniopatch, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4178", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Flowerderm, per square centimeter", "description": "Flowerderm, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4179", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Revita, per square centimeter", "description": "Revita, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amnio wound, per square centimeter", "description": "Amnio wound, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcyte, per square centimeter", "description": "Transcyte, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4182", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgigraft, per square centimeter", "description": "Surgigraft, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4183", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cellesta or cellesta duo, per square centimeter", "description": "Cellesta or cellesta duo, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4184", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cellesta flowable amnion (25 mg per cc); per 0.5 cc", "description": "Cellesta flowable amnion (25 mg per cc); per 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Epifix, per square centimeter", "description": "Epifix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Epicord, per square centimeter", "description": "Epicord, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4187", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amnioarmor, per square centimeter", "description": "Amnioarmor, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4188", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artacent ac, 1 mg", "description": "Artacent ac, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4189", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artacent ac, per square centimeter", "description": "Artacent ac, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Restorigin, per square centimeter", "description": "Restorigin, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4191", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Restorigin, 1 cc", "description": "Restorigin, 1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4192", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coll-e-derm, per square centimeter", "description": "Coll-e-derm, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4193", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Novachor, per square centimeter", "description": "Novachor, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4194", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Puraply, per square centimeter", "description": "Puraply, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4195", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Puraply am, per square centimeter", "description": "Puraply am, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4196", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Puraply xt, per square centimeter", "description": "Puraply xt, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4197", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Genesis amniotic membrane, per square centimeter", "description": "Genesis amniotic membrane, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4198", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Skin te, per square centimeter", "description": "Skin te, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Matrion, per square centimeter", "description": "Matrion, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Keroxx (2.5g/cc), 1cc", "description": "Keroxx (2.5g/cc), 1cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Derma-gide, per square centimeter", "description": "Derma-gide, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Xwrap, per square centimeter", "description": "Xwrap, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Membrane graft or membrane wrap, per square centimeter", "description": "Membrane graft or membrane wrap, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fluid flow or fluid gf, 1 cc", "description": "Fluid flow or fluid gf, 1 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Novafix, per square cenitmeter", "description": "Novafix, per square cenitmeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgraft, per square centimeter", "description": "Surgraft, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Axolotl graft or axolotl dualgraft, per square centimeter", "description": "Axolotl graft or axolotl dualgraft, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amnion bio or axobiomembrane, per square centimeter", "description": "Amnion bio or axobiomembrane, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Allogen, per cc", "description": "Allogen, per cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ascent, 0.5 mg", "description": "Ascent, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cellesta cord, per square centimeter", "description": "Cellesta cord, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Axolotl ambient or axolotl cryo, 0.1 mg", "description": "Axolotl ambient or axolotl cryo, 0.1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artacent cord, per square centimeter", "description": "Artacent cord, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4216", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter", "description": "Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4217", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgicord, per square centimeter", "description": "Surgicord, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4218", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surgigraft-dual, per square centimeter", "description": "Surgigraft-dual, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4219", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bellacell hd or surederm, per square centimeter", "description": "Bellacell hd or surederm, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniowrap2, per square centimeter", "description": "Amniowrap2, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Progenamatrix, per square centimeter", "description": "Progenamatrix, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4222", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Myown skin, includes harvesting and preparation procedures, per square centimeter", "description": "Myown skin, includes harvesting and preparation procedures, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4226", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniocore, per square centimeter", "description": "Amniocore, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4227", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bionextpatch, per square centimeter", "description": "Bionextpatch, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4228", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cogenex amniotic membrane, per square centimeter", "description": "Cogenex amniotic membrane, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4229", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cogenex flowable amnion, per 0.5 cc", "description": "Cogenex flowable amnion, per 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Corplex p, per cc", "description": "Corplex p, per cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4231", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Corplex, per square centimeter", "description": "Corplex, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4232", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Surfactor or nudyn, per 0.5 cc", "description": "Surfactor or nudyn, per 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4233", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Xcellerate, per square centimeter", "description": "Xcellerate, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4234", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniorepair or altiply, per square centimeter", "description": "Amniorepair or altiply, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4235", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Carepatch, per square centimeter", "description": "Carepatch, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4236", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cryo-cord, per square centimeter", "description": "Cryo-cord, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4237", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Derm-maxx, per square centimeter", "description": "Derm-maxx, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4238", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amnio-maxx or amnio-maxx lite, per square centimeter", "description": "Amnio-maxx or amnio-maxx lite, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4239", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Corecyte, for topical use only, per 0.5 cc", "description": "Corecyte, for topical use only, per 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Polycyte, for topical use only, per 0.5 cc", "description": "Polycyte, for topical use only, per 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4241", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniocyte plus, per 0.5 cc", "description": "Amniocyte plus, per 0.5 cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4242", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Procenta, per 200 mg", "description": "Procenta, per 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4244", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniotext, per cc", "description": "Amniotext, per cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coretext or protext, per cc", "description": "Coretext or protext, per cc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniotext patch, per square centimeter", "description": "Amniotext patch, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dermacyte amniotic membrane allograft, per square centimeter", "description": "Dermacyte amniotic membrane allograft, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniply, for topical use only, per square centimeter", "description": "Amniply, for topical use only, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4249", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amnioamp-mp, per square centimeter", "description": "Amnioamp-mp, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vim, per square centimeter", "description": "Vim, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4251", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vendaje, per square centimeter", "description": "Vendaje, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4252", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Zenith amniotic membrane, per square centimeter", "description": "Zenith amniotic membrane, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4253", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Novafix dl, per square centimeter", "description": "Novafix dl, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4254", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reguard, for topical use only, per square centimeter", "description": "Reguard, for topical use only, per square centimeter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q4255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice or home health care provided in patient's home/residence", "description": "Hospice or home health care provided in patient's home/residence", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice or home health care provided in assisted living facility", "description": "Hospice or home health care provided in assisted living facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf)", "description": "Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice care provided in skilled nursing facility (snf)", "description": "Hospice care provided in skilled nursing facility (snf)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice care provided in inpatient hospital", "description": "Hospice care provided in inpatient hospital", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice care provided in inpatient hospice facility", "description": "Hospice care provided in inpatient hospice facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice care provided in long term care facility", "description": "Hospice care provided in long term care facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice care provided in inpatient psychiatric facility", "description": "Hospice care provided in inpatient psychiatric facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice or home health care provided in place not otherwise specified (nos)", "description": "Hospice or home health care provided in place not otherwise specified (nos)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice home care provided in a hospice facility", "description": "Hospice home care provided in a hospice facility", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram", "description": "Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, infliximab, biosimilar, 10 mg", "description": "Injection, infliximab, biosimilar, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg", "description": "Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5103", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, infliximab-abda, biosimilar, (renflexis), 10 mg", "description": "Injection, infliximab-abda, biosimilar, (renflexis), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5104", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units", "description": "Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units", "description": "Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5106", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg", "description": "Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5107", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg", "description": "Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5108", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg", "description": "Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5109", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram", "description": "Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg", "description": "Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5111", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg", "description": "Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg", "description": "Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg", "description": "Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5114", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rituximab-abbs, biosimilar, (truxima), 10 mg", "description": "Injection, rituximab-abbs, biosimilar, (truxima), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5115", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg", "description": "Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5116", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg", "description": "Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg", "description": "Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5118", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg", "description": "Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5119", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg", "description": "Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, infliximab-axxq, biosimilar, (avsola), 10 mg", "description": "Injection, infliximab-axxq, biosimilar, (avsola), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg", "description": "Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, rituximab-arrx, biosimilar, (riabni), 10 mg", "description": "Injection, rituximab-arrx, biosimilar, (riabni), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q5123", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assessment by department of veterans affairs chaplain services", "description": "Assessment by department of veterans affairs chaplain services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Counseling, individual, by department of veterans affairs chaplain services", "description": "Counseling, individual, by department of veterans affairs chaplain services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Counseling, group, by department of veterans affairs chaplain services", "description": "Counseling, group, by department of veterans affairs chaplain services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Department of veterans affairs whole health partner services", "description": "Department of veterans affairs whole health partner services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sulfur hexafluoride lipid microspheres, per ml", "description": "Injection, sulfur hexafluoride lipid microspheres, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml", "description": "Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9951", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, iron-based magnetic resonance contrast agent, per ml", "description": "Injection, iron-based magnetic resonance contrast agent, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9953", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oral magnetic resonance contrast agent, per 100 ml", "description": "Oral magnetic resonance contrast agent, per 100 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9954", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, perflexane lipid microspheres, per ml", "description": "Injection, perflexane lipid microspheres, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9955", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, octafluoropropane microspheres, per ml", "description": "Injection, octafluoropropane microspheres, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9956", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, perflutren lipid microspheres, per ml", "description": "Injection, perflutren lipid microspheres, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9957", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml", "description": "High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9958", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml", "description": "High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9959", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml", "description": "High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml", "description": "High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9961", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml", "description": "High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9962", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml", "description": "High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9963", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml", "description": "High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9964", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml", "description": "Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9965", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml", "description": "Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9966", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml", "description": "Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9967", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg", "description": "Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9968", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose", "description": "Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9969", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferric carboxymaltose, 1mg", "description": "Injection, ferric carboxymaltose, 1mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin beta, 1 microgram, (for esrd on dialysis)", "description": "Injection, epoetin beta, 1 microgram, (for esrd on dialysis)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9972", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, epoetin beta, 1 microgram, (non-esrd use)", "description": "Injection, epoetin beta, 1 microgram, (non-esrd use)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9973", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg", "description": "Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9974", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, factor viii fc fusion protein (recombinant), per iu", "description": "Injection, factor viii fc fusion protein (recombinant), per iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9975", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ferric pyrophosphate citrate solution, 0.1 mg of iron", "description": "Injection, ferric pyrophosphate citrate solution, 0.1 mg of iron", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9976", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compounded drug, not otherwise classified", "description": "Compounded drug, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9977", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Netupitant 300 mg and palonosetron 0.5 mg", "description": "Netupitant 300 mg and palonosetron 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9978", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, alemtuzumab, 1 mg", "description": "Injection, alemtuzumab, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9979", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hyaluronan or derivative, genvisc 850, for intra-articular injection, 1 mg", "description": "Hyaluronan or derivative, genvisc 850, for intra-articular injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9980", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rolapitant, oral, 1 mg", "description": "Rolapitant, oral, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9981", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries", "description": "Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries", "description": "Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9983", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mg", "description": "Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9984", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg", "description": "Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9985", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydroxyprogesterone caproate, (makena), 10 mg", "description": "Injection, hydroxyprogesterone caproate, (makena), 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9986", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pathogen(s) test for platelets", "description": "Pathogen(s) test for platelets", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9987", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Platelets, pheresis, pathogen-reduced, each unit", "description": "Platelets, pheresis, pathogen-reduced, each unit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9988", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ustekinumab, for intravenous injection, 1 mg", "description": "Ustekinumab, for intravenous injection, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9989", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg", "description": "Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9991", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, buprenorphine extended-release (sublocade), greater than 100 mg", "description": "Injection, buprenorphine extended-release (sublocade), greater than 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9992", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg", "description": "Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9993", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "In-line cartridge containing digestive enzyme(s) for enteral feeding, each", "description": "In-line cartridge containing digestive enzyme(s) for enteral feeding, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9994", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, emicizumab-kxwh, 0.5 mg", "description": "Injection, emicizumab-kxwh, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "Q9995", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen", "description": "Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "R0070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen", "description": "Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "R0075", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transportation of portable ekg to facility or location, per patient", "description": "Transportation of portable ekg to facility or location, per patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "R0076", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Butorphanol tartrate, nasal spray, 25 mg", "description": "Butorphanol tartrate, nasal spray, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Esketamine, nasal spray, 1 mg", "description": "Esketamine, nasal spray, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tacrine hydrochloride, 10 mg", "description": "Tacrine hydrochloride, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aminocaproic acid, 5 grams", "description": "Injection, aminocaproic acid, 5 grams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bupivicaine hydrochloride, 30 ml", "description": "Injection, bupivicaine hydrochloride, 30 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cefoperazone sodium, 1 gram", "description": "Injection, cefoperazone sodium, 1 gram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cimetidine hydrochloride, 300 mg", "description": "Injection, cimetidine hydrochloride, 300 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, famotidine, 20 mg", "description": "Injection, famotidine, 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, metronidazole, 500 mg", "description": "Injection, metronidazole, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, nafcillin sodium, 2 grams", "description": "Injection, nafcillin sodium, 2 grams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ofloxacin, 400 mg", "description": "Injection, ofloxacin, 400 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, sulfamethoxazole and trimethoprim, 10 ml", "description": "Injection, sulfamethoxazole and trimethoprim, 10 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ticarcillin disodium and clavulanate potassium, 3.1 grams", "description": "Injection, ticarcillin disodium and clavulanate potassium, 3.1 grams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, aztreonam, 500 mg", "description": "Injection, aztreonam, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0073", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, cefotetan disodium, 500 mg", "description": "Injection, cefotetan disodium, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0074", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, clindamycin phosphate, 300 mg", "description": "Injection, clindamycin phosphate, 300 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0077", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, fosphenytoin sodium, 750 mg", "description": "Injection, fosphenytoin sodium, 750 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0078", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pentamidine isethionate, 300 mg", "description": "Injection, pentamidine isethionate, 300 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, piperacillin sodium, 500 mg", "description": "Injection, piperacillin sodium, 500 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0081", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Imatinib, 100 mg", "description": "Imatinib, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0088", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sildenafil citrate, 25 mg", "description": "Sildenafil citrate, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)", "description": "Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0091", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)", "description": "Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0092", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, morphine sulfate, 500 mg (loading dose for infusion pump)", "description": "Injection, morphine sulfate, 500 mg (loading dose for infusion pump)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0093", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Zidovudine, oral, 100 mg", "description": "Zidovudine, oral, 100 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0104", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets", "description": "Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0106", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mercaptopurine, oral, 50 mg", "description": "Mercaptopurine, oral, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0108", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Methadone, oral, 5 mg", "description": "Methadone, oral, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0109", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tretinoin, topical, 5 grams", "description": "Tretinoin, topical, 5 grams", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)", "description": "Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0119", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, menotropins, 75 iu", "description": "Injection, menotropins, 75 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, follitropin alfa, 75 iu", "description": "Injection, follitropin alfa, 75 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, follitropin beta, 75 iu", "description": "Injection, follitropin beta, 75 iu", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0128", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, ganirelix acetate, 250 mcg", "description": "Injection, ganirelix acetate, 250 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0132", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clozapine, 25 mg", "description": "Clozapine, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0136", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Didanosine (ddi), 25 mg", "description": "Didanosine (ddi), 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0137", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Finasteride, 5 mg", "description": "Finasteride, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0138", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Minoxidil, 10 mg", "description": "Minoxidil, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0139", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Saquinavir, 200 mg", "description": "Saquinavir, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg", "description": "Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0142", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, propofol, 10 mg", "description": "Injection, propofol, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0144", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegylated interferon alfa-2a, 180 mcg per ml", "description": "Injection, pegylated interferon alfa-2a, 180 mcg per ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pegylated interferon alfa-2b, 10 mcg", "description": "Injection, pegylated interferon alfa-2b, 10 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0148", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sterile dilutant for epoprostenol, 50 ml", "description": "Sterile dilutant for epoprostenol, 50 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0155", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Exemestane, 25 mg", "description": "Exemestane, 25 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0156", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Becaplermin gel 0.01%, 0.5 gm", "description": "Becaplermin gel 0.01%, 0.5 gm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0157", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dextroamphetamine sulfate, 5 mg", "description": "Dextroamphetamine sulfate, 5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, pantoprazole sodium, 40 mg", "description": "Injection, pantoprazole sodium, 40 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0164", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, olanzapine, 2.5 mg", "description": "Injection, olanzapine, 2.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0166", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Calcitrol, 0.25 microgram", "description": "Calcitrol, 0.25 microgram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0169", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anastrozole, oral, 1 mg", "description": "Anastrozole, oral, 1 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Injection, bumetanide, 0.5 mg", "description": "Injection, bumetanide, 0.5 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chlorambucil, oral, 2 mg", "description": "Chlorambucil, oral, 2 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0172", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)", "description": "Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0174", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Flutamide, oral, 125 mg", "description": "Flutamide, oral, 125 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": 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"setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Megestrol acetate, oral, 20 mg", "description": "Megestrol acetate, oral, 20 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0179", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Procarbazine hydrochloride, oral, 50 mg", "description": "Procarbazine hydrochloride, oral, 50 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0182", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164)", "description": "Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0183", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tamoxifen citrate, oral, 10 mg", "description": "Tamoxifen citrate, oral, 10 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0187", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Testosterone pellet, 75 mg", "description": "Testosterone pellet, 75 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0189", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mifepristone, oral, 200 mg", "description": "Mifepristone, oral, 200 mg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Misoprostol, oral, 200 mcg", "description": "Misoprostol, oral, 200 mcg", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0191", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dialysis/stress vitamin supplement, oral, 100 capsules", "description": "Dialysis/stress vitamin supplement, oral, 100 capsules", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0194", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pneumococcal conjugate vaccine, polyvalent, intramuscular, for children from five years to nine years of age who have not previously received the vaccine", "description": "Pneumococcal conjugate vaccine, polyvalent, intramuscular, for children from five years to nine years of age who have not previously received the vaccine", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0195", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prenatal vitamins, 30-day supply", "description": "Prenatal vitamins, 30-day supply", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0197", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs", "description": "Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Partial hospitalization services, less than 24 hours, per diem", "description": "Partial hospitalization services, less than 24 hours, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0201", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Paramedic intercept, non-hospital-based als service (non-voluntary), non-transport", "description": "Paramedic intercept, non-hospital-based als service (non-voluntary), non-transport", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Paramedic intercept, hospital-based als service (non-voluntary), non-transport", "description": "Paramedic intercept, hospital-based als service (non-voluntary), non-transport", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wheelchair van, mileage, per mile", "description": "Wheelchair van, mileage, per mile", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation; mileage, per mile", "description": "Non-emergency transportation; mileage, per mile", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes", "description": "Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes", "description": "Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive geriatric assessment and treatment planning performed by assessment team", "description": "Comprehensive geriatric assessment and treatment planning performed by assessment team", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff", "description": "Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)", "description": "Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)", "description": "History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Genetic counseling, under physician supervision, each 15 minutes", "description": "Genetic counseling, under physician supervision, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician management of patient home care, standard monthly case rate (per 30 days)", "description": "Physician management of patient home care, standard monthly case rate (per 30 days)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician management of patient home care, hospice monthly case rate (per 30 days)", "description": "Physician management of patient home care, hospice monthly case rate (per 30 days)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0271", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician management of patient home care, episodic care monthly case rate (per 30 days)", "description": "Physician management of patient home care, episodic care monthly case rate (per 30 days)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0272", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physician visit at member's home, outside of a capitation arrangement", "description": "Physician visit at member's home, outside of a capitation arrangement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0273", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nurse practitioner visit at member's home, outside of a capitation arrangement", "description": "Nurse practitioner visit at member's home, outside of a capitation arrangement", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0274", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical home program, comprehensive care coordination and planning, initial plan", "description": "Medical home program, comprehensive care coordination and planning, initial plan", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0280", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical home program, comprehensive care coordination and planning, maintenance of plan", "description": "Medical home program, comprehensive care coordination and planning, maintenance of plan", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0281", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Colonoscopy consultation performed prior to a screening colonoscopy procedure", "description": "Colonoscopy consultation performed prior to a screening colonoscopy procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)", "description": "Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0302", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospitalist services (list separately in addition to code for appropriate evaluation and management service)", "description": "Hospitalist services (list separately in addition to code for appropriate evaluation and management service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive management and care coordination for advanced illness, per calendar month", "description": "Comprehensive management and care coordination for advanced illness, per calendar month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0311", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disease management program; initial assessment and initiation of the program", "description": "Disease management program; initial assessment and initiation of the program", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disease management program, follow-up/reassessment", "description": "Disease management program, follow-up/reassessment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0316", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disease management program; per diem", "description": "Disease management program; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0317", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telephone calls by a registered nurse to a disease management program member for monitoring purposes; per month", "description": "Telephone calls by a registered nurse to a disease management program member for monitoring purposes; per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage", "description": "Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lifestyle modification program for management of coronary artery disease, including all supportive services; second or third quarter / stage", "description": "Lifestyle modification program for management of coronary artery disease, including all supportive services; second or third quarter / stage", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0341", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lifestyle modification program for management of coronary artery disease, including all supportive services; fourth quarter / stage", "description": "Lifestyle modification program for management of coronary artery disease, including all supportive services; fourth quarter / stage", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0342", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Treatment planning and care coordination management for cancer, initial treatment", "description": "Treatment planning and care coordination management for cancer, initial treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0353", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Treatment planning and care coordination management for cancer, established patient with a change of regimen", "description": "Treatment planning and care coordination management for cancer, established patient with a change of regimen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0354", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit", "description": "Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0390", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic", "description": "Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0395", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s)", "description": "Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable contact lens, per lens", "description": "Disposable contact lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Single vision prescription lens (safety, athletic, or sunglass), per lens", "description": "Single vision prescription lens (safety, athletic, or sunglass), per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bifocal vision prescription lens (safety, athletic, or sunglass), per lens", "description": "Bifocal vision prescription lens (safety, athletic, or sunglass), per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0506", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trifocal vision prescription lens (safety, athletic, or sunglass), per lens", "description": "Trifocal vision prescription lens (safety, athletic, or sunglass), per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0508", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-prescription lens (safety, athletic, or sunglass), per lens", "description": "Non-prescription lens (safety, athletic, or sunglass), per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Daily wear specialty contact lens, per lens", "description": "Daily wear specialty contact lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Color contact lens, per lens", "description": "Color contact lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0514", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Scleral lens, liquid bandage device, per lens", "description": "Scleral lens, liquid bandage device, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0515", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Safety eyeglass frames", "description": "Safety eyeglass frames", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0516", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sunglasses frames", "description": "Sunglasses frames", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0518", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Polycarbonate lens (list this code in addition to the basic code for the lens)", "description": "Polycarbonate lens (list this code in addition to the basic code for the lens)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0580", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nonstandard lens (list this code in addition to the basic code for the lens)", "description": "Nonstandard lens (list this code in addition to the basic code for the lens)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0581", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Integral lens service, miscellaneous services reported separately", "description": "Integral lens service, miscellaneous services reported separately", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive contact lens evaluation", "description": "Comprehensive contact lens evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0592", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dispensing new spectacle lenses for patient supplied frame", "description": "Dispensing new spectacle lenses for patient supplied frame", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0595", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Phakic intraocular lens for correction of refractive error", "description": "Phakic intraocular lens for correction of refractive error", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0596", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening proctoscopy", "description": "Screening proctoscopy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0601", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Annual gynecological examination, new patient", "description": "Annual gynecological examination, new patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Annual gynecological examination, established patient", "description": "Annual gynecological examination, established patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0612", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Annual gynecological examination; clinical breast examination without pelvic evaluation", "description": "Annual gynecological examination; clinical breast examination without pelvic evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0613", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Audiometry for hearing aid evaluation to determine the level and degree of hearing loss", "description": "Audiometry for hearing aid evaluation to determine the level and degree of hearing loss", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0618", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Routine ophthalmological examination including refraction; new patient", "description": "Routine ophthalmological examination including refraction; new patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0620", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Routine ophthalmological examination including refraction; established patient", "description": "Routine ophthalmological examination including refraction; established patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0621", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physical exam for college, new or established patient (list separately in addition to appropriate evaluation and management code)", "description": "Physical exam for college, new or established patient (list separately in addition to appropriate evaluation and management code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0622", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Removal of sutures; by a physician other than the physician who originally closed the wound", "description": "Removal of sutures; by a physician other than the physician who originally closed the wound", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laser in situ keratomileusis (lasik)", "description": "Laser in situ keratomileusis (lasik)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0800", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Photorefractive keratectomy (prk)", "description": "Photorefractive keratectomy (prk)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Phototherapeutic keratectomy (ptk)", "description": "Phototherapeutic keratectomy (ptk)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S0812", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Deluxe item, patient aware (list in addition to code for basic item)", "description": "Deluxe item, patient aware (list in addition to code for basic item)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Customized item (list in addition to code for basic item)", "description": "Customized item (list in addition to code for basic item)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iv tubing extension set", "description": "Iv tubing extension set", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-pvc (polyvinyl chloride) intravenous administration set, for use with drugs that are not stable in pvc e.g., paclitaxel", "description": "Non-pvc (polyvinyl chloride) intravenous administration set, for use with drugs that are not stable in pvc e.g., paclitaxel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Continuous noninvasive glucose monitoring device, purchase (for physician interpretation of data, use cpt code)", "description": "Continuous noninvasive glucose monitoring device, purchase (for physician interpretation of data, use cpt code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Continuous noninvasive glucose monitoring device, rental, including sensor, sensor replacement, and download to monitor (for physician interpretation of data, use cpt code)", "description": "Continuous noninvasive glucose monitoring device, rental, including sensor, sensor replacement, and download to monitor (for physician interpretation of data, use cpt code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Artificial pancreas device system (e.g., low glucose suspend (lgs) feature) including continuous glucose monitor, blood glucose device, insulin pump and computer algorithm that communicates with all of the devices", "description": "Artificial pancreas device system (e.g., low glucose suspend (lgs) feature) including continuous glucose monitor, blood glucose device, insulin pump and computer algorithm that communicates with all of the devices", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sensor; invasive (e.g., subcutaneous), disposable, for use with artificial pancreas device system", "description": "Sensor; invasive (e.g., subcutaneous), disposable, for use with artificial pancreas device system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transmitter; external, for use with artificial pancreas device system", "description": "Transmitter; external, for use with artificial pancreas device system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Receiver (monitor); external, for use with artificial pancreas device system", "description": "Receiver (monitor); external, for use with artificial pancreas device system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)", "description": "Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mometasone furoate sinus implant, 370 micrograms", "description": "Mometasone furoate sinus implant, 370 micrograms", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stent, non-coronary, temporary, with delivery system (propel)", "description": "Stent, non-coronary, temporary, with delivery system (propel)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S1091", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transplantation of small intestine and liver allografts", "description": "Transplantation of small intestine and liver allografts", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2053", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transplantation of multivisceral organs", "description": "Transplantation of multivisceral organs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2054", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor", "description": "Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lobar lung transplantation", "description": "Lobar lung transplantation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Donor lobectomy (lung) for transplantation, living donor", "description": "Donor lobectomy (lung) for transplantation, living donor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2061", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Simultaneous pancreas kidney transplantation", "description": "Simultaneous pancreas kidney transplantation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2065", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral", "description": "Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2066", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast reconstruction of a single breast with \"stacked\" deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascular transfer, closure of donor site(s) and shaping the flap into a breast, unilateral", "description": "Breast reconstruction of a single breast with \"stacked\" deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascular transfer, closure of donor site(s) and shaping the flap into a breast, unilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2067", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral", "description": "Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2068", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization)", "description": "Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laparoscopic esophagomyotomy (heller type)", "description": "Laparoscopic esophagomyotomy (heller type)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2079", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laser-assisted uvulopalatoplasty (laup)", "description": "Laser-assisted uvulopalatoplasty (laup)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline", "description": "Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres", "description": "Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2095", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Islet cell tissue transplant from pancreas; allogeneic", "description": "Islet cell tissue transplant from pancreas; allogeneic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adrenal tissue transplant to brain", "description": "Adrenal tissue transplant to brain", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2103", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adoptive immunotherapy i.e. development of specific anti-tumor reactivity (e.g., tumor-infiltrating lymphocyte therapy) per course of treatment", "description": "Adoptive immunotherapy i.e. development of specific anti-tumor reactivity (e.g., tumor-infiltrating lymphocyte therapy) per course of treatment", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2107", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells)", "description": "Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Osteotomy, periacetabular, with internal fixation", "description": "Osteotomy, periacetabular, with internal fixation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2115", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Arthroereisis, subtalar", "description": "Arthroereisis, subtalar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Metal-on-metal total hip resurfacing, including acetabular and femoral components", "description": "Metal-on-metal total hip resurfacing, including acetabular and femoral components", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2118", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation", "description": "Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cord blood harvesting for transplantation, allogeneic", "description": "Cord blood harvesting for transplantation, allogeneic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cord blood-derived stem-cell transplantation, allogeneic", "description": "Cord blood-derived stem-cell transplantation, allogeneic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2142", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre-and post-transplant care in the global definition", "description": "Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre-and post-transplant care in the global definition", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services, and the number of days of pre- and post-transplant care in the global definition", "description": "Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services, and the number of days of pre- and post-transplant care in the global definition", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2152", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Echosclerotherapy", "description": "Echosclerotherapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft", "description": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts", "description": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft", "description": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous graft", "description": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous graft", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft", "description": "Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Myringotomy, laser-assisted", "description": "Myringotomy, laser-assisted", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2225", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear", "description": "Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Implantation of auditory brain stem implant", "description": "Implantation of auditory brain stem implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2235", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Induced abortion, 17 to 24 weeks", "description": "Induced abortion, 17 to 24 weeks", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Induced abortion, 25 to 28 weeks", "description": "Induced abortion, 25 to 28 weeks", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Induced abortion, 29 to 31 weeks", "description": "Induced abortion, 29 to 31 weeks", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2266", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Induced abortion, 32 weeks or greater", "description": "Induced abortion, 32 weeks or greater", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2267", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy", "description": "Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hip core decompression", "description": "Hip core decompression", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chemodenervation of abductor muscle(s) of vocal cord", "description": "Chemodenervation of abductor muscle(s) of vocal cord", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chemodenervation of adductor muscle(s) of vocal cord", "description": "Chemodenervation of adductor muscle(s) of vocal cord", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2341", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral", "description": "Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2342", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar", "description": "Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2348", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace", "description": "Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2350", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure)", "description": "Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2351", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; cervical", "description": "Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; cervical", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2360", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Each additional cervical vertebral body (list separately in addition to code for primary procedure)", "description": "Each additional cervical vertebral body (list separately in addition to code for primary procedure)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2361", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero", "description": "Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2400", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair, urinary tract obstruction in the fetus, procedure performed in utero", "description": "Repair, urinary tract obstruction in the fetus, procedure performed in utero", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2401", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero", "description": "Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2402", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero", "description": "Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2403", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair, myelomeningocele in the fetus, procedure performed in utero", "description": "Repair, myelomeningocele in the fetus, procedure performed in utero", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S2404", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", 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"additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "5% dextrose in lactated ringer's, 1000 ml", "description": "5% dextrose in lactated ringer's, 1000 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "5% dextrose with potassium chloride, 1000 ml", "description": "5% dextrose with potassium chloride, 1000 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1000 ml", "description": "5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1000 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1500 ml", "description": "5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1500 ml", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, routine service of infusion device (e.g., pump maintenance)", "description": "Home infusion therapy, routine service of infusion device (e.g., pump maintenance)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, repair of infusion device (e.g., pump repair)", "description": "Home infusion therapy, repair of infusion device (e.g., pump repair)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Day care services, adult; per 15 minutes", "description": "Day care services, adult; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Day care services, adult; per half day", "description": "Day care services, adult; per half day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Day care services, adult; per diem", "description": "Day care services, adult; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Day care services, center-based; services not included in program fee, per diem", "description": "Day care services, center-based; services not included in program fee, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home care training to home care client, per 15 minutes", "description": "Home care training to home care client, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5108", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home care training to home care client, per session", "description": "Home care training to home care client, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5109", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home care training, family; per 15 minutes", "description": "Home care training, family; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home care training, family; per session", "description": "Home care training, family; per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5111", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home care training, non-family; per 15 minutes", "description": "Home care training, non-family; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5115", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home care training, non-family; per session", "description": "Home care training, non-family; per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5116", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chore services; per 15 minutes", "description": "Chore services; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Chore services; per diem", "description": "Chore services; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Attendant care services; per 15 minutes", "description": "Attendant care services; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5125", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Attendant care services; per diem", "description": "Attendant care services; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Homemaker service, nos; per 15 minutes", "description": "Homemaker service, nos; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Homemaker service, nos; per diem", "description": "Homemaker service, nos; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Companion care, adult (e.g., iadl/adl); per 15 minutes", "description": "Companion care, adult (e.g., iadl/adl); per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5135", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Companion care, adult (e.g., iadl/adl); per diem", "description": "Companion care, adult (e.g., iadl/adl); per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5136", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foster care, adult; per diem", "description": "Foster care, adult; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foster care, adult; per month", "description": "Foster care, adult; per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5141", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foster care, therapeutic, child; per diem", "description": "Foster care, therapeutic, child; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Foster care, therapeutic, child; per month", "description": "Foster care, therapeutic, child; per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5146", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unskilled respite care, not hospice; per 15 minutes", "description": "Unskilled respite care, not hospice; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Unskilled respite care, not hospice; per diem", "description": "Unskilled respite care, not hospice; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5151", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency response system; installation and testing", "description": "Emergency response system; installation and testing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency response system; service fee, per month (excludes installation and testing)", "description": "Emergency response system; service fee, per month (excludes installation and testing)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5161", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Emergency response system; purchase only", "description": "Emergency response system; purchase only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5162", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home modifications; per service", "description": "Home modifications; per service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5165", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home delivered meals, including preparation; per meal", "description": "Home delivered meals, including preparation; per meal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Laundry service, external, professional; per order", "description": "Laundry service, external, professional; per order", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5175", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home health respiratory therapy, initial evaluation", "description": "Home health respiratory therapy, initial evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home health respiratory therapy, nos, per diem", "description": "Home health respiratory therapy, nos, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medication reminder service, non-face-to-face; per month", "description": "Medication reminder service, non-face-to-face; per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Wellness assessment, performed by non-physician", "description": "Wellness assessment, performed by non-physician", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Personal care item, nos, each", "description": "Personal care item, nos, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5497", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, catheter care / maintenance, simple (single lumen), includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, catheter care / maintenance, simple (single lumen), includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5498", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (use this code for interim maintenance of vascular access not currently in use)", "description": "Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (use this code for interim maintenance of vascular access not currently in use)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, all supplies necessary for restoration of catheter patency or declotting", "description": "Home infusion therapy, all supplies necessary for restoration of catheter patency or declotting", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5517", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, all supplies necessary for catheter repair", "description": "Home infusion therapy, all supplies necessary for catheter repair", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5518", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, all supplies (including catheter) necessary for a peripherally inserted central venous catheter (picc) line insertion", "description": "Home infusion therapy, all supplies (including catheter) necessary for a peripherally inserted central venous catheter (picc) line insertion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, all supplies (including catheter) necessary for a midline catheter insertion", "description": "Home infusion therapy, all supplies (including catheter) necessary for a midline catheter insertion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5521", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included)", "description": "Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5522", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included)", "description": "Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5523", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin, rapid onset, 5 units", "description": "Insulin, rapid onset, 5 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5550", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin, most rapid onset (lispro or aspart); 5 units", "description": "Insulin, most rapid onset (lispro or aspart); 5 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5551", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin, intermediate acting (nph or lente); 5 units", "description": "Insulin, intermediate acting (nph or lente); 5 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5552", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin, long acting; 5 units", "description": "Insulin, long acting; 5 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5553", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin delivery device, reusable pen; 1.5 ml size", "description": "Insulin delivery device, reusable pen; 1.5 ml size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin delivery device, reusable pen; 3 ml size", "description": "Insulin delivery device, reusable pen; 3 ml size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5561", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin cartridge for use in insulin delivery device other than pump; 150 units", "description": "Insulin cartridge for use in insulin delivery device other than pump; 150 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5565", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin cartridge for use in insulin delivery device other than pump; 300 units", "description": "Insulin cartridge for use in insulin delivery device other than pump; 300 units", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5566", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin delivery device, disposable pen (including insulin); 1.5 ml size", "description": "Insulin delivery device, disposable pen (including insulin); 1.5 ml size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5570", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin delivery device, disposable pen (including insulin); 3 ml size", "description": "Insulin delivery device, disposable pen (including insulin); 3 ml size", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5571", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy", "description": "Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Low-dose computed tomography for lung cancer screening", "description": "Low-dose computed tomography for lung cancer screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic source imaging", "description": "Magnetic source imaging", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance cholangiopancreatography (mrcp)", "description": "Magnetic resonance cholangiopancreatography (mrcp)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Topographic brain mapping", "description": "Topographic brain mapping", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Magnetic resonance imaging (mri), low-field", "description": "Magnetic resonance imaging (mri), low-field", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultrasound guidance for multifetal pregnancy reduction(s), technical component (only to be used when the physician doing the reduction procedure does not perform the ultrasound, guidance is included in the cpt code for multifetal pregnancy reduction - 59866)", "description": "Ultrasound guidance for multifetal pregnancy reduction(s), technical component (only to be used when the physician doing the reduction procedure does not perform the ultrasound, guidance is included in the cpt code for multifetal pregnancy reduction - 59866)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical", "description": "Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fluorine-18 fluorodeoxyglucose (f-18 fdg) imaging using dual-head coincidence detection system (non-dedicated pet scan)", "description": "Fluorine-18 fluorodeoxyglucose (f-18 fdg) imaging using dual-head coincidence detection system (non-dedicated pet scan)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8085", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electron beam computed tomography (also known as ultrafast ct, cine ct)", "description": "Electron beam computed tomography (also known as ultrafast ct, cine ct)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8092", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Portable peak flow meter", "description": "Portable peak flow meter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8096", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Asthma kit (including but not limited to portable peak expiratory flow meter, instructional video, brochure, and/or spacer)", "description": "Asthma kit (including but not limited to portable peak expiratory flow meter, instructional video, brochure, and/or spacer)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8097", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Holding chamber or spacer for use with an inhaler or nebulizer; without mask", "description": "Holding chamber or spacer for use with an inhaler or nebulizer; without mask", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Holding chamber or spacer for use with an inhaler or nebulizer; with mask", "description": "Holding chamber or spacer for use with an inhaler or nebulizer; with mask", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Peak expiratory flow rate (physician services)", "description": "Peak expiratory flow rate (physician services)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen contents, gaseous, 1 unit equals 1 cubic foot", "description": "Oxygen contents, gaseous, 1 unit equals 1 cubic foot", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oxygen contents, liquid, 1 unit equals 1 pound", "description": "Oxygen contents, liquid, 1 unit equals 1 pound", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interferential current stimulator, 2 channel", "description": "Interferential current stimulator, 2 channel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Interferential current stimulator, 4 channel", "description": "Interferential current stimulator, 4 channel", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Flutter device", "description": "Flutter device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8185", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Swivel adapter", "description": "Swivel adapter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8186", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tracheostomy supply, not otherwise classified", "description": "Tracheostomy supply, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8189", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mucus trap", "description": "Mucus trap", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mandibular orthopedic repositioning device, each", "description": "Mandibular orthopedic repositioning device, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8262", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Haberman feeder for cleft lip/palate", "description": "Haberman feeder for cleft lip/palate", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enuresis alarm, using auditory buzzer and/or vibration device", "description": "Enuresis alarm, using auditory buzzer and/or vibration device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infection control supplies, not otherwise specified", "description": "Infection control supplies, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supplies for home delivery of infant", "description": "Supplies for home delivery of infant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8415", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (sleeve and glove combination), custom made", "description": "Gradient pressure aid (sleeve and glove combination), custom made", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8420", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (sleeve and glove combination), ready made", "description": "Gradient pressure aid (sleeve and glove combination), ready made", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8421", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (sleeve), custom made, medium weight", "description": "Gradient pressure aid (sleeve), custom made, medium weight", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8422", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (sleeve), custom made, heavy weight", "description": "Gradient pressure aid (sleeve), custom made, heavy weight", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8423", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (sleeve), ready made", "description": "Gradient pressure aid (sleeve), ready made", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8424", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (glove), custom made, medium weight", "description": "Gradient pressure aid (glove), custom made, medium weight", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8425", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (glove), custom made, heavy weight", "description": "Gradient pressure aid (glove), custom made, heavy weight", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8426", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (glove), ready made", "description": "Gradient pressure aid (glove), ready made", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8427", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure aid (gauntlet), ready made", "description": "Gradient pressure aid (gauntlet), ready made", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8428", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Gradient pressure exterior wrap", "description": "Gradient pressure exterior wrap", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8429", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Padding for compression bandage, roll", "description": "Padding for compression bandage, roll", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Compression bandage, roll", "description": "Compression bandage, roll", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8431", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Splint, prefabricated, digit (specify digit by use of modifier)", "description": "Splint, prefabricated, digit (specify digit by use of modifier)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8450", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Splint, prefabricated, wrist or ankle", "description": "Splint, prefabricated, wrist or ankle", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8451", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Splint, prefabricated, elbow", "description": "Splint, prefabricated, elbow", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Camisole, post-mastectomy", "description": "Camisole, post-mastectomy", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin syringes (100 syringes, any size)", "description": "Insulin syringes (100 syringes, any size)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with the patient", "description": "Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with the patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8930", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Equestrian/hippotherapy, per session", "description": "Equestrian/hippotherapy, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8940", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes", "description": "Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8948", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Complex lymphedema therapy, each 15 minutes", "description": "Complex lymphedema therapy, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8950", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physical or manipulative therapy performed for maintenance rather than restoration", "description": "Physical or manipulative therapy performed for maintenance rather than restoration", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8990", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)", "description": "Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S8999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home uterine monitor with or without associated nursing services", "description": "Home uterine monitor with or without associated nursing services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ultrafiltration monitor", "description": "Ultrafiltration monitor", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Automated eeg monitoring", "description": "Automated eeg monitoring", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Paranasal sinus ultrasound", "description": "Paranasal sinus ultrasound", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Omnicardiogram/cardiointegram", "description": "Omnicardiogram/cardiointegram", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265)", "description": "Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Procuren or other growth factor preparation to promote wound healing", "description": "Procuren or other growth factor preparation to promote wound healing", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9055", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Coma stimulation per diem", "description": "Coma stimulation per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9056", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home administration of aerosolized drug therapy (e.g., pentamidine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home administration of aerosolized drug therapy (e.g., pentamidine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9061", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Global fee urgent care centers", "description": "Global fee urgent care centers", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9083", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services provided in an urgent care center (list in addition to code for service)", "description": "Services provided in an urgent care center (list in addition to code for service)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9088", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vertebral axial decompression, per session", "description": "Vertebral axial decompression, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home visit for wound care", "description": "Home visit for wound care", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9097", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home visit, phototherapy services (e.g., bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem", "description": "Home visit, phototherapy services (e.g., bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9098", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month", "description": "Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Back school, per visit", "description": "Back school, per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9117", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home health aide or certified nurse assistant, providing care in the home; per hour", "description": "Home health aide or certified nurse assistant, providing care in the home; per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9122", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)", "description": "Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9123", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nursing care, in the home; by licensed practical nurse, per hour", "description": "Nursing care, in the home; by licensed practical nurse, per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9124", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Respite care, in the home, per diem", "description": "Respite care, in the home, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9125", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice care, in the home, per diem", "description": "Hospice care, in the home, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9126", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Social work visit, in the home, per diem", "description": "Social work visit, in the home, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9127", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Speech therapy, in the home, per diem", "description": "Speech therapy, in the home, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9128", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Occupational therapy, in the home, per diem", "description": "Occupational therapy, in the home, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9129", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Physical therapy; in the home, per diem", "description": "Physical therapy; in the home, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9131", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetic management program, follow-up visit to non-md provider", "description": "Diabetic management program, follow-up visit to non-md provider", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetic management program, follow-up visit to md provider", "description": "Diabetic management program, follow-up visit to md provider", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9141", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Insulin pump initiation, instruction in initial use of pump (pump not included)", "description": "Insulin pump initiation, instruction in initial use of pump (pump not included)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9145", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Evaluation by ocularist", "description": "Evaluation by ocularist", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Speech therapy, re-evaluation", "description": "Speech therapy, re-evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9152", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home management of preterm labor, including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)", "description": "Home management of preterm labor, including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home management of preterm premature rupture of membranes (pprom), including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)", "description": "Home management of preterm premature rupture of membranes (pprom), including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home management of gestational hypertension, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)", "description": "Home management of gestational hypertension, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home management of postpartum hypertension, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)", "description": "Home management of postpartum hypertension, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home management of preeclampsia, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately); per diem (do not use this code with any home infusion per diem code)", "description": "Home management of preeclampsia, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately); per diem (do not use this code with any home infusion per diem code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)", "description": "Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (do not use this code with s9326, s9327 or s9328)", "description": "Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (do not use this code with s9326, s9327 or s9328)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9325", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, continuous (twenty-four hours or more) pain management infusion; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, continuous (twenty-four hours or more) pain management infusion; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9326", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, intermittent (less than twenty-four hours) pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, intermittent (less than twenty-four hours) pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9327", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9328", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with s9330 or s9331)", "description": "Home infusion therapy, chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with s9330 or s9331)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9329", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, continuous (twenty-four hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, continuous (twenty-four hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9330", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, intermittent (less than twenty-four hours) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, intermittent (less than twenty-four hours) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9331", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy, hemodialysis; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately), per diem", "description": "Home therapy, hemodialysis; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9335", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, continuous anticoagulant infusion therapy (e.g., heparin), administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, continuous anticoagulant infusion therapy (e.g., heparin), administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9336", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9338", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy; peritoneal dialysis, administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home therapy; peritoneal dialysis, administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9339", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem", "description": "Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9340", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem", "description": "Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9341", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem", "description": "Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9342", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem", "description": "Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9343", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, anti-hemophilic agent infusion therapy (e.g., factor viii); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, anti-hemophilic agent infusion therapy (e.g., factor viii); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9345", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, alpha-1-proteinase inhibitor (e.g., prolastin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, alpha-1-proteinase inhibitor (e.g., prolastin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9346", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, uninterrupted, long-term, controlled rate intravenous or subcutaneous infusion therapy (e.g., epoprostenol); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, uninterrupted, long-term, controlled rate intravenous or subcutaneous infusion therapy (e.g., epoprostenol); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9347", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, sympathomimetic/inotropic agent infusion therapy (e.g., dobutamine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, sympathomimetic/inotropic agent infusion therapy (e.g., dobutamine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9348", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, tocolytic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, tocolytic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9349", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and visits coded separately), per diem", "description": "Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9351", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, continuous insulin infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, continuous insulin infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9353", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, chelation therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, chelation therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9355", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, enzyme replacement intravenous therapy; (e.g., imiglucerase); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, enzyme replacement intravenous therapy; (e.g., imiglucerase); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9357", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, anti-tumor necrosis factor intravenous therapy; (e.g., infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, anti-tumor necrosis factor intravenous therapy; (e.g., infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9359", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, diuretic intravenous therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, diuretic intravenous therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9361", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, anti-spasmotic therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, anti-spasmotic therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9363", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, total parenteral nutrition (tpn); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem (do not use with home infusion codes s9365-s9368 using daily volume scales)", "description": "Home infusion therapy, total parenteral nutrition (tpn); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem (do not use with home infusion codes s9365-s9368 using daily volume scales)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, total parenteral nutrition (tpn); one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem", "description": "Home infusion therapy, total parenteral nutrition (tpn); one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9365", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem", "description": "Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9366", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem", "description": "Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9367", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, total parenteral nutrition (tpn); more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem", "description": "Home infusion therapy, total parenteral nutrition (tpn); more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9368", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy, intermittent anti-emetic injection therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home therapy, intermittent anti-emetic injection therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9370", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy; intermittent anticoagulant injection therapy (e.g., heparin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code for flushing of infusion devices with heparin to maintain patency)", "description": "Home therapy; intermittent anticoagulant injection therapy (e.g., heparin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code for flushing of infusion devices with heparin to maintain patency)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9372", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, hydration therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use with hydration therapy codes s9374-s9377 using daily volume scales)", "description": "Home infusion therapy, hydration therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use with hydration therapy codes s9374-s9377 using daily volume scales)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9373", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9374", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, hydration therapy; more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, hydration therapy; more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9375", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, hydration therapy; more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, hydration therapy; more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9376", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, hydration therapy; more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, hydration therapy; more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9377", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9379", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Delivery or service to high risk areas requiring escort or extra protection, per visit", "description": "Delivery or service to high risk areas requiring escort or extra protection, per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9381", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anticoagulation clinic, inclusive of all services except laboratory tests, per session", "description": "Anticoagulation clinic, inclusive of all services except laboratory tests, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9401", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pharmacy compounding and dispensing services", "description": "Pharmacy compounding and dispensing services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical foods for non-inborn errors of metabolism", "description": "Medical foods for non-inborn errors of metabolism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9432", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical food nutritionally complete, administered orally, providing 100% of nutritional intake", "description": "Medical food nutritionally complete, administered orally, providing 100% of nutritional intake", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9433", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Modified solid food supplements for inborn errors of metabolism", "description": "Modified solid food supplements for inborn errors of metabolism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9434", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical foods for inborn errors of metabolism", "description": "Medical foods for inborn errors of metabolism", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9435", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Childbirth preparation/lamaze classes, non-physician provider, per session", "description": "Childbirth preparation/lamaze classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9436", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Childbirth refresher classes, non-physician provider, per session", "description": "Childbirth refresher classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9437", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cesarean birth classes, non-physician provider, per session", "description": "Cesarean birth classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9438", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vbac (vaginal birth after cesarean) classes, non-physician provider, per session", "description": "Vbac (vaginal birth after cesarean) classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9439", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Asthma education, non-physician provider, per session", "description": "Asthma education, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9441", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Birthing classes, non-physician provider, per session", "description": "Birthing classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9442", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lactation classes, non-physician provider, per session", "description": "Lactation classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9443", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Parenting classes, non-physician provider, per session", "description": "Parenting classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9444", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient education, not otherwise classified, non-physician provider, individual, per session", "description": "Patient education, not otherwise classified, non-physician provider, individual, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9445", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Patient education, not otherwise classified, non-physician provider, group, per session", "description": "Patient education, not otherwise classified, non-physician provider, group, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9446", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Infant safety (including cpr) classes, non-physician provider, per session", "description": "Infant safety (including cpr) classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9447", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Weight management classes, non-physician provider, per session", "description": "Weight management classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9449", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Exercise classes, non-physician provider, per session", "description": "Exercise classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9451", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nutrition classes, non-physician provider, per session", "description": "Nutrition classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9452", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Smoking cessation classes, non-physician provider, per session", "description": "Smoking cessation classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9453", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Stress management classes, non-physician provider, per session", "description": "Stress management classes, non-physician provider, per session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9454", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetic management program, group session", "description": "Diabetic management program, group session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9455", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetic management program, nurse visit", "description": "Diabetic management program, nurse visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9460", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diabetic management program, dietitian visit", "description": "Diabetic management program, dietitian visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9465", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nutritional counseling, dietitian visit", "description": "Nutritional counseling, dietitian visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9470", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Cardiac rehabilitation program, non-physician provider, per diem", "description": "Cardiac rehabilitation program, non-physician provider, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9472", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pulmonary rehabilitation program, non-physician provider, per diem", "description": "Pulmonary rehabilitation program, non-physician provider, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9473", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem", "description": "Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9474", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulatory setting substance abuse treatment or detoxification services, per diem", "description": "Ambulatory setting substance abuse treatment or detoxification services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9475", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vestibular rehabilitation program, non-physician provider, per diem", "description": "Vestibular rehabilitation program, non-physician provider, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9476", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intensive outpatient psychiatric services, per diem", "description": "Intensive outpatient psychiatric services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9480", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Family stabilization services, per 15 minutes", "description": "Family stabilization services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9482", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crisis intervention mental health services, per hour", "description": "Crisis intervention mental health services, per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9484", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crisis intervention mental health services, per diem", "description": "Crisis intervention mental health services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9485", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, corticosteroid infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, corticosteroid infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9490", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with home infusion codes for hourly dosing schedules s9497-s9504)", "description": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with home infusion codes for hourly dosing schedules s9497-s9504)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9494", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9497", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, antibiotic, antiviral, or antifungal; once every 6 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, antibiotic, antiviral, or antifungal; once every 6 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home infusion therapy, antibiotic, antiviral, or antifungal; once every 4 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home infusion therapy, antibiotic, antiviral, or antifungal; once every 4 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9504", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Routine venipuncture for collection of specimen(s), single home bound, nursing home, or skilled nursing facility patient", "description": "Routine venipuncture for collection of specimen(s), single home bound, nursing home, or skilled nursing facility patient", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9529", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy; hematopoietic hormone injection therapy (e.g., erythropoietin, g-csf, gm-csf); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home therapy; hematopoietic hormone injection therapy (e.g., erythropoietin, g-csf, gm-csf); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9537", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home transfusion of blood product(s); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (blood products, drugs, and nursing visits coded separately), per diem", "description": "Home transfusion of blood product(s); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (blood products, drugs, and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9538", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9542", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home injectable therapy; growth hormone, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home injectable therapy; growth hormone, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9558", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home injectable therapy, interferon, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home injectable therapy, interferon, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9559", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home injectable therapy; hormonal therapy (e.g.; leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home injectable therapy; hormonal therapy (e.g.; leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9560", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home injectable therapy, palivizumab, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home injectable therapy, palivizumab, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9562", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy, irrigation therapy (e.g., sterile irrigation of an organ or anatomical cavity); including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "description": "Home therapy, irrigation therapy (e.g., sterile irrigation of an organ or anatomical cavity); including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9590", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code)", "description": "Home therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9810", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services by a journal-listed christian science practitioner for the purpose of healing, per diem", "description": "Services by a journal-listed christian science practitioner for the purpose of healing, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9900", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services by a journal-listed christian science nurse, per hour", "description": "Services by a journal-listed christian science nurse, per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9901", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, conventional air service, nonemergency transport, one way (fixed wing)", "description": "Ambulance service, conventional air service, nonemergency transport, one way (fixed wing)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9960", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ambulance service, conventional air service, nonemergency transport, one way (rotary wing)", "description": "Ambulance service, conventional air service, nonemergency transport, one way (rotary wing)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9961", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Health club membership, annual", "description": "Health club membership, annual", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9970", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transplant related lodging, meals and transportation, per diem", "description": "Transplant related lodging, meals and transportation, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9975", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lodging, per diem, not otherwise classified", "description": "Lodging, per diem, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9976", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Meals, per diem, not otherwise specified", "description": "Meals, per diem, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9977", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical records copying fee, administrative", "description": "Medical records copying fee, administrative", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9981", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medical records copying fee, per page", "description": "Medical records copying fee, per page", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9982", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Not medically necessary service (patient is aware that service not medically necessary)", "description": "Not medically necessary service (patient is aware that service not medically necessary)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9986", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services provided as part of a phase i clinical trial", "description": "Services provided as part of a phase i clinical trial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9988", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services provided outside of the united states of america (list in addition to code(s) for service(s))", "description": "Services provided outside of the united states of america (list in addition to code(s) for service(s))", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9989", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services provided as part of a phase ii clinical trial", "description": "Services provided as part of a phase ii clinical trial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9990", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services provided as part of a phase iii clinical trial", "description": "Services provided as part of a phase iii clinical trial", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9991", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transportation costs to and from trial location and local transportation costs (e.g., fares for taxicab or bus) for clinical trial participant and one caregiver/companion", "description": "Transportation costs to and from trial location and local transportation costs (e.g., fares for taxicab or bus) for clinical trial participant and one caregiver/companion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9992", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lodging costs (e.g., hotel charges) for clinical trial participant and one caregiver/companion", "description": "Lodging costs (e.g., hotel charges) for clinical trial participant and one caregiver/companion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9994", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Meals for clinical trial participant and one caregiver/companion", "description": "Meals for clinical trial participant and one caregiver/companion", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9996", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sales tax", "description": "Sales tax", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Private duty / independent nursing service(s) - licensed, up to 15 minutes", "description": "Private duty / independent nursing service(s) - licensed, up to 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1000", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nursing assessment / evaluation", "description": "Nursing assessment / evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Rn services, up to 15 minutes", "description": "Rn services, up to 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lpn/lvn services, up to 15 minutes", "description": "Lpn/lvn services, up to 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Services of a qualified nursing aide, up to 15 minutes", "description": "Services of a qualified nursing aide, up to 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Respite care services, up to 15 minutes", "description": "Respite care services, up to 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or substance abuse services, family/couple counseling", "description": "Alcohol and/or substance abuse services, family/couple counseling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1006", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or substance abuse services, treatment plan development and/or modification", "description": "Alcohol and/or substance abuse services, treatment plan development and/or modification", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Child sitting services for children of the individual receiving alcohol and/or substance abuse services", "description": "Child sitting services for children of the individual receiving alcohol and/or substance abuse services", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1009", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Meals for individuals receiving alcohol and/or substance abuse services (when meals not included in the program)", "description": "Meals for individuals receiving alcohol and/or substance abuse services (when meals not included in the program)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Alcohol and/or substance abuse services, skills development", "description": "Alcohol and/or substance abuse services, skills development", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sign language or oral interpretive services, per 15 minutes", "description": "Sign language or oral interpretive services, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telehealth transmission, per minute, professional services bill separately", "description": "Telehealth transmission, per minute, professional services bill separately", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Clinic visit/encounter, all-inclusive", "description": "Clinic visit/encounter, all-inclusive", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Case management, each 15 minutes", "description": "Case management, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Targeted case management, each 15 minutes", "description": "Targeted case management, each 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "School-based individualized education program (iep) services, bundled", "description": "School-based individualized education program (iep) services, bundled", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)", "description": "Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)", "description": "Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Home health aide or certified nurse assistant, per visit", "description": "Home health aide or certified nurse assistant, per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contracted home health agency services, all services provided under contract, per day", "description": "Contracted home health agency services, all services provided under contract, per day", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter", "description": "Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter", "description": "Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem", "description": "Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, medical and psychosocial impairments, per hour", "description": "Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, medical and psychosocial impairments, per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Family training and counseling for child development, per 15 minutes", "description": "Family training and counseling for child development, per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs", "description": "Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Comprehensive environmental lead investigation, not including laboratory analysis, per dwelling", "description": "Comprehensive environmental lead investigation, not including laboratory analysis, per dwelling", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nursing care, in the home, by registered nurse, per diem", "description": "Nursing care, in the home, by registered nurse, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Nursing care, in the home, by licensed practical nurse, per diem", "description": "Nursing care, in the home, by licensed practical nurse, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medicaid certified community behavioral health clinic services, per diem", "description": "Medicaid certified community behavioral health clinic services, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Medicaid certified community behavioral health clinic services, per month", "description": "Medicaid certified community behavioral health clinic services, per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit", "description": "Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Administration of medication, other than oral and/or injectable, by a health care agency/professional, per visit", "description": "Administration of medication, other than oral and/or injectable, by a health care agency/professional, per visit", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Electronic medication compliance management device, includes all components and accessories, not otherwise classified", "description": "Electronic medication compliance management device, includes all components and accessories, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1505", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in \"remarks\"", "description": "Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in \"remarks\"", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1999", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation; patient attendant/escort", "description": "Non-emergency transportation; patient attendant/escort", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation; per diem", "description": "Non-emergency transportation; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2002", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation; encounter/trip", "description": "Non-emergency transportation; encounter/trip", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transport; commercial carrier, multi-pass", "description": "Non-emergency transport; commercial carrier, multi-pass", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2004", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Non-emergency transportation; stretcher van", "description": "Non-emergency transportation; stretcher van", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2005", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments", "description": "Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2007", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preadmission screening and resident review (pasrr) level i identification screening, per screen", "description": "Preadmission screening and resident review (pasrr) level i identification screening, per screen", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Preadmission screening and resident review (pasrr) level ii evaluation, per evaluation", "description": "Preadmission screening and resident review (pasrr) level ii evaluation, per evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, educational; waiver, per diem", "description": "Habilitation, educational; waiver, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2012", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, educational, waiver; per hour", "description": "Habilitation, educational, waiver; per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2013", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, prevocational, waiver; per diem", "description": "Habilitation, prevocational, waiver; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, prevocational, waiver; per hour", "description": "Habilitation, prevocational, waiver; per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2015", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, residential, waiver; per diem", "description": "Habilitation, residential, waiver; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2016", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, residential, waiver; 15 minutes", "description": "Habilitation, residential, waiver; 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2017", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, supported employment, waiver; per diem", "description": "Habilitation, supported employment, waiver; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2018", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, supported employment, waiver; per 15 minutes", "description": "Habilitation, supported employment, waiver; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2019", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Day habilitation, waiver; per diem", "description": "Day habilitation, waiver; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Day habilitation, waiver; per 15 minutes", "description": "Day habilitation, waiver; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2021", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Case management, per month", "description": "Case management, per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2022", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Targeted case management; per month", "description": "Targeted case management; per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2023", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Service assessment/plan of care development, waiver", "description": "Service assessment/plan of care development, waiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2024", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Waiver services; not otherwise specified (nos)", "description": "Waiver services; not otherwise specified (nos)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2025", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialized childcare, waiver; per diem", "description": "Specialized childcare, waiver; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2026", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialized childcare, waiver; per 15 minutes", "description": "Specialized childcare, waiver; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2027", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialized supply, not otherwise specified, waiver", "description": "Specialized supply, not otherwise specified, waiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2028", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialized medical equipment, not otherwise specified, waiver", "description": "Specialized medical equipment, not otherwise specified, waiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2029", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assisted living, waiver; per month", "description": "Assisted living, waiver; per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assisted living; waiver, per diem", "description": "Assisted living; waiver, per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2031", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Residential care, not otherwise specified (nos), waiver; per month", "description": "Residential care, not otherwise specified (nos), waiver; per month", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2032", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Residential care, not otherwise specified (nos), waiver; per diem", "description": "Residential care, not otherwise specified (nos), waiver; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2033", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Crisis intervention, waiver; per diem", "description": "Crisis intervention, waiver; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2034", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Utility services to support medical equipment and assistive technology/devices, waiver", "description": "Utility services to support medical equipment and assistive technology/devices, waiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2035", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic camping, overnight, waiver; each session", "description": "Therapeutic camping, overnight, waiver; each session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2036", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Therapeutic camping, day, waiver; each session", "description": "Therapeutic camping, day, waiver; each session", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2037", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Community transition, waiver; per service", "description": "Community transition, waiver; per service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2038", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vehicle modifications, waiver; per service", "description": "Vehicle modifications, waiver; per service", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2039", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Financial management, self-directed, waiver; per 15 minutes", "description": "Financial management, self-directed, waiver; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supports brokerage, self-directed, waiver; per 15 minutes", "description": "Supports brokerage, self-directed, waiver; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2041", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice routine home care; per diem", "description": "Hospice routine home care; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2042", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice continuous home care; per hour", "description": "Hospice continuous home care; per hour", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2043", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice inpatient respite care; per diem", "description": "Hospice inpatient respite care; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2044", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice general inpatient care; per diem", "description": "Hospice general inpatient care; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2045", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hospice long term care, room and board only; per diem", "description": "Hospice long term care, room and board only; per diem", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2046", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Habilitation, prevocational, waiver; per 15 minutes", "description": "Habilitation, prevocational, waiver; per 15 minutes", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2047", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem", "description": "Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), 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{100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Human breast milk processing, storage and distribution only", "description": "Human breast milk processing, storage and distribution only", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T2101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult sized disposable incontinence product, brief/diaper, small, each", "description": "Adult sized disposable incontinence product, brief/diaper, small, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", 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"outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult sized disposable incontinence product, brief/diaper, large, each", "description": "Adult sized disposable incontinence product, brief/diaper, large, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4523", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult sized disposable incontinence product, brief/diaper, extra large, each", "description": "Adult sized disposable incontinence product, brief/diaper, extra large, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4524", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult sized disposable incontinence product, protective underwear/pull-on, small size, each", "description": "Adult sized disposable incontinence product, protective underwear/pull-on, small size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4525", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", 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{2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each", "description": "Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4529", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediatric sized disposable incontinence product, brief/diaper, large size, each", "description": "Pediatric sized disposable incontinence product, brief/diaper, large size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each", "description": "Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4531", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each", "description": "Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4532", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Youth sized disposable incontinence product, brief/diaper, each", "description": "Youth sized disposable incontinence product, brief/diaper, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4533", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Youth sized disposable incontinence product, protective underwear/pull-on, each", "description": "Youth sized disposable incontinence product, protective underwear/pull-on, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4534", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Disposable liner/shield/guard/pad/undergarment, for incontinence, each", "description": "Disposable liner/shield/guard/pad/undergarment, for incontinence, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4535", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence product, protective underwear/pull-on, reusable, any size, each", "description": "Incontinence product, protective underwear/pull-on, reusable, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4536", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence product, protective underpad, reusable, bed size, each", "description": "Incontinence product, protective underpad, reusable, bed size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4537", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Diaper service, reusable diaper, each diaper", "description": "Diaper service, reusable diaper, each diaper", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4538", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence product, diaper/brief, reusable, any size, each", "description": "Incontinence product, diaper/brief, reusable, any size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4539", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence product, protective underpad, reusable, chair size, each", "description": "Incontinence product, protective underpad, reusable, chair size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4540", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence product, disposable underpad, large, each", "description": "Incontinence product, disposable underpad, large, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4541", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence product, disposable underpad, small size, each", "description": "Incontinence product, disposable underpad, small size, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4542", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult sized disposable incontinence product, protective brief/diaper, above extra large, each", "description": "Adult sized disposable incontinence product, protective brief/diaper, above extra large, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4543", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each", "description": "Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4544", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Incontinence product, disposable, penile wrap, each", "description": "Incontinence product, disposable, penile wrap, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T4545", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Positioning seat for persons with special orthopedic needs", "description": "Positioning seat for persons with special orthopedic needs", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T5001", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Supply, not otherwise specified", "description": "Supply, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": 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described by cms-2020-01-r", "description": "Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "U0003", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r", "description": 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"outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphere, single vision, plano to plus or minus 4.00, per lens", "description": "Sphere, single vision, plano to plus or minus 4.00, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens", "description": "Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2101", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens", "description": "Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2102", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, 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"2022", "billing_code": "V2104", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens", "description": "Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2105", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": 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"negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens", "description": "Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2109", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens", "description": "Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens", "description": "Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2111", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens", "description": "Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2112", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens", "description": "Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2113", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens", "description": "Spherocylinder, single vision, sphere over plus or minus 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"billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aniseikonic lens, single vision", "description": "Aniseikonic lens, single vision", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2118", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lenticular lens, per lens, single", "description": "Lenticular lens, per lens, single", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2121", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Not otherwise classified, single vision lens", "description": "Not otherwise classified, single vision lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2199", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphere, bifocal, plano to plus or minus 4.00d, per lens", "description": "Sphere, bifocal, plano to plus or minus 4.00d, per lens", "negotiation_arrangement": "ffs", 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"professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens", "description": "Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2202", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2203", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2204", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2205", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2206", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2207", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2208", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2209", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens", "description": "Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens", "description": "Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens", "description": "Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lenticular (myodisc), per lens, bifocal", "description": "Lenticular (myodisc), per lens, bifocal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aniseikonic, per lens, bifocal", "description": "Aniseikonic, per lens, bifocal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2218", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bifocal seg width over 28 mm", "description": "Bifocal seg width over 28 mm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2219", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Bifocal add over 3.25d", "description": "Bifocal add over 3.25d", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lenticular lens, per lens, bifocal", "description": "Lenticular lens, per lens, bifocal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty bifocal (by report)", "description": "Specialty bifocal (by report)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2299", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphere, trifocal, plano to plus or minus 4.00d, per lens", "description": "Sphere, trifocal, plano to plus or minus 4.00d, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2300", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens", "description": "Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2301", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens", "description": "Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2302", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2303", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2304", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens", "description": "Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2305", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2306", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2307", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2308", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2309", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2310", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens", "description": "Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2311", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2312", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens", "description": "Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2313", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens", "description": "Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2314", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lenticular, (myodisc), per lens, trifocal", "description": "Lenticular, (myodisc), per lens, trifocal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2315", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Aniseikonic lens, trifocal", "description": "Aniseikonic lens, trifocal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2318", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trifocal seg width over 28 mm", "description": "Trifocal seg width over 28 mm", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2319", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Trifocal add over 3.25d", "description": "Trifocal add over 3.25d", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2320", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lenticular lens, per lens, trifocal", "description": "Lenticular lens, per lens, trifocal", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2321", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty trifocal (by report)", "description": "Specialty trifocal (by report)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2399", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Variable asphericity lens, single vision, full field, glass or plastic, per lens", "description": "Variable asphericity lens, single vision, full field, glass or plastic, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2410", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Variable asphericity lens, bifocal, full field, glass or plastic, per lens", "description": "Variable asphericity lens, bifocal, full field, glass or plastic, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2430", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Variable sphericity lens, other type", "description": "Variable sphericity lens, other type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2499", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, pmma, spherical, per lens", "description": "Contact lens, pmma, spherical, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2500", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, pmma, toric or prism ballast, per lens", "description": "Contact lens, pmma, toric or prism ballast, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2501", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, pmma, bifocal, per lens", "description": "Contact lens, pmma, bifocal, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2502", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, pmma, color vision deficiency, per lens", "description": "Contact lens, pmma, color vision deficiency, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2503", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, gas permeable, spherical, per lens", "description": "Contact lens, gas permeable, spherical, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2510", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, gas permeable, toric, prism ballast, per lens", "description": "Contact lens, gas permeable, toric, prism ballast, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2511", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, gas permeable, bifocal, per lens", "description": "Contact lens, gas permeable, bifocal, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2512", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, gas permeable, extended wear, per lens", "description": "Contact lens, gas permeable, extended wear, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2513", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, hydrophilic, spherical, per lens", "description": "Contact lens, hydrophilic, spherical, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2520", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, hydrophilic, toric, or prism ballast, per lens", "description": "Contact lens, hydrophilic, toric, or prism ballast, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2521", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, hydrophilic, bifocal, per lens", "description": "Contact lens, hydrophilic, bifocal, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2522", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, hydrophilic, extended wear, per lens", "description": "Contact lens, hydrophilic, extended wear, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2523", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, hydrophilic, spherical, photochromic additive, per lens", "description": "Contact lens, hydrophilic, spherical, photochromic additive, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2524", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)", "description": "Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2530", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)", "description": "Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2531", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Contact lens, other type", "description": "Contact lens, other type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2599", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hand held low vision aids and other nonspectacle mounted aids", "description": "Hand held low vision aids and other nonspectacle mounted aids", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2600", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Single lens spectacle mounted low vision aids", "description": "Single lens spectacle mounted low vision aids", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2610", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Telescopic and other compound lens system, including distance vision telescopic, near vision telescopes and compound microscopic lens system", "description": "Telescopic and other compound lens system, including distance vision telescopic, near vision telescopes and compound microscopic lens system", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2615", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic eye, plastic, custom", "description": "Prosthetic eye, plastic, custom", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2623", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Polishing/resurfacing of ocular prosthesis", "description": "Polishing/resurfacing of ocular prosthesis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2624", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Enlargement of ocular prosthesis", "description": "Enlargement of ocular prosthesis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2625", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Reduction of ocular prosthesis", "description": "Reduction of ocular prosthesis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2626", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Scleral cover shell", "description": "Scleral cover shell", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2627", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fabrication and fitting of ocular conformer", "description": "Fabrication and fitting of ocular conformer", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2628", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prosthetic eye, other type", "description": "Prosthetic eye, other type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2629", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anterior chamber intraocular lens", "description": "Anterior chamber intraocular lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2630", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Iris supported intraocular lens", "description": "Iris supported intraocular lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2631", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Posterior chamber intraocular lens", "description": "Posterior chamber intraocular lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2632", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Balance lens, per lens", "description": "Balance lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2700", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Deluxe lens feature", "description": "Deluxe lens feature", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2702", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Slab off prism, glass or plastic, per lens", "description": "Slab off prism, glass or plastic, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2710", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Prism, per lens", "description": "Prism, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2715", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Press-on lens, fresnell prism, per lens", "description": "Press-on lens, fresnell prism, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2718", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Special base curve, glass or plastic, per lens", "description": "Special base curve, glass or plastic, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2730", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Tint, photochromatic, per lens", "description": "Tint, photochromatic, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2744", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens", "description": "Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2745", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Anti-reflective coating, per lens", "description": "Anti-reflective coating, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2750", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "U-v lens, per lens", "description": "U-v lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2755", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Eye glass case", "description": "Eye glass case", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2756", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Scratch resistant coating, per lens", "description": "Scratch resistant coating, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2760", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Mirror coating, any type, solid, gradient or equal, any lens material, per lens", "description": "Mirror coating, any type, solid, gradient or equal, any lens material, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2761", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Polarization, any lens material, per lens", "description": "Polarization, any lens material, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2762", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Occluder lens, per lens", "description": "Occluder lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2770", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Oversize lens, per lens", "description": "Oversize lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2780", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Progressive lens, per lens", "description": "Progressive lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2781", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens", "description": "Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2782", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens", "description": "Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2783", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Lens, polycarbonate or equal, any index, per lens", "description": "Lens, polycarbonate or equal, any index, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2784", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Processing, preserving and transporting corneal tissue", "description": "Processing, preserving and transporting corneal tissue", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2785", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Specialty occupational multifocal lens, per lens", "description": "Specialty occupational multifocal lens, per lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2786", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Astigmatism correcting function of intraocular lens", "description": "Astigmatism correcting function of intraocular lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2787", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Presbyopia correcting function of intraocular lens", "description": "Presbyopia correcting function of intraocular lens", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2788", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Amniotic membrane for surgical reconstruction, per procedure", "description": "Amniotic membrane for surgical reconstruction, per procedure", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2790", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vision supply, accessory and/or service component of another hcpcs vision code", "description": "Vision supply, accessory and/or service component of another hcpcs vision code", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2797", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Vision item or service, miscellaneous", "description": "Vision item or service, miscellaneous", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V2799", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing screening", "description": "Hearing screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5008", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assessment for hearing aid", "description": "Assessment for hearing aid", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5010", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Fitting/orientation/checking of hearing aid", "description": "Fitting/orientation/checking of hearing aid", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5011", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair/modification of a hearing aid", "description": "Repair/modification of a hearing aid", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5014", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Conformity evaluation", "description": "Conformity evaluation", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5020", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, monaural, body worn, air conduction", "description": "Hearing aid, monaural, body worn, air conduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5030", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, monaural, body worn, bone conduction", "description": "Hearing aid, monaural, body worn, bone conduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5040", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, monaural, in the ear", "description": "Hearing aid, monaural, in the ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5050", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, monaural, behind the ear", "description": "Hearing aid, monaural, behind the ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5060", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Glasses, air conduction", "description": "Glasses, air conduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5070", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Glasses, bone conduction", "description": "Glasses, bone conduction", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5080", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dispensing fee, unspecified hearing aid", "description": "Dispensing fee, unspecified hearing aid", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5090", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Semi-implantable middle ear hearing prosthesis", "description": "Semi-implantable middle ear hearing prosthesis", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5095", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, bilateral, body worn", "description": "Hearing aid, bilateral, body worn", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5100", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dispensing fee, bilateral", "description": "Dispensing fee, bilateral", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5110", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Binaural, body", "description": "Binaural, body", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5120", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Binaural, in the ear", "description": "Binaural, in the ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5130", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Binaural, behind the ear", "description": "Binaural, behind the ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5140", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Binaural, glasses", "description": "Binaural, glasses", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5150", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dispensing fee, binaural", "description": "Dispensing fee, binaural", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5160", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, cros, in the ear", "description": "Hearing aid, cros, in the ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5170", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing device, monaural, in the ear (ite)", "description": "Hearing aid, contralateral routing device, monaural, in the ear (ite)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5171", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing device, monaural, in the canal (itc)", "description": "Hearing aid, contralateral routing device, monaural, in the canal (itc)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5172", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, cros, behind the ear", "description": "Hearing aid, cros, behind the ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5180", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing device, monaural, behind the ear (bte)", "description": "Hearing aid, contralateral routing device, monaural, behind the ear (bte)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5181", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing, monaural, glasses", "description": "Hearing aid, contralateral routing, monaural, glasses", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5190", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dispensing fee, contralateral, monaural", "description": "Dispensing fee, contralateral, monaural", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5200", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, bicros, in the ear", "description": "Hearing aid, bicros, in the ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5210", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing system, binaural, ite/ite", "description": "Hearing aid, contralateral routing system, binaural, ite/ite", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5211", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing system, binaural, ite/itc", "description": "Hearing aid, contralateral routing system, binaural, ite/itc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5212", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing system, binaural, ite/bte", "description": "Hearing aid, contralateral routing system, binaural, ite/bte", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5213", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing system, binaural, itc/itc", "description": "Hearing aid, contralateral routing system, binaural, itc/itc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5214", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing system, binaural, itc/bte", "description": "Hearing aid, contralateral routing system, binaural, itc/bte", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5215", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, bicros, behind the ear", "description": "Hearing aid, bicros, behind the ear", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5220", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing system, binaural, bte/bte", "description": "Hearing aid, contralateral routing system, binaural, bte/bte", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5221", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, contralateral routing system, binaural, glasses", "description": "Hearing aid, contralateral routing system, binaural, glasses", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5230", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dispensing fee, contralateral routing system, binaural", "description": "Dispensing fee, contralateral routing system, binaural", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5240", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dispensing fee, monaural hearing aid, any type", "description": "Dispensing fee, monaural hearing aid, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5241", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, analog, monaural, cic (completely in the ear canal)", "description": "Hearing aid, analog, monaural, cic (completely in the ear canal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5242", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, analog, monaural, itc (in the canal)", "description": "Hearing aid, analog, monaural, itc (in the canal)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5243", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digitally programmable analog, monaural, cic", "description": "Hearing aid, digitally programmable analog, monaural, cic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5244", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digitally programmable, analog, monaural, itc", "description": "Hearing aid, digitally programmable, analog, monaural, itc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5245", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digitally programmable analog, monaural, ite (in the ear)", "description": "Hearing aid, digitally programmable analog, monaural, ite (in the ear)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5246", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digitally programmable analog, monaural, bte (behind the ear)", "description": "Hearing aid, digitally programmable analog, monaural, bte (behind the ear)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5247", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, analog, binaural, cic", "description": "Hearing aid, analog, binaural, cic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5248", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, analog, binaural, itc", "description": "Hearing aid, analog, binaural, itc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5249", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digitally programmable analog, binaural, cic", "description": "Hearing aid, digitally programmable analog, binaural, cic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5250", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digitally programmable analog, binaural, itc", "description": "Hearing aid, digitally programmable analog, binaural, itc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5251", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digitally programmable, binaural, ite", "description": "Hearing aid, digitally programmable, binaural, ite", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5252", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digitally programmable, binaural, bte", "description": "Hearing aid, digitally programmable, binaural, bte", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5253", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digital, monaural, cic", "description": "Hearing aid, digital, monaural, cic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5254", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digital, monaural, itc", "description": "Hearing aid, digital, monaural, itc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5255", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digital, monaural, ite", "description": "Hearing aid, digital, monaural, ite", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5256", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digital, monaural, bte", "description": "Hearing aid, digital, monaural, bte", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5257", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digital, binaural, cic", "description": "Hearing aid, digital, binaural, cic", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5258", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digital, binaural, itc", "description": "Hearing aid, digital, binaural, itc", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5259", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digital, binaural, ite", "description": "Hearing aid, digital, binaural, ite", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5260", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, digital, binaural, bte", "description": "Hearing aid, digital, binaural, bte", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5261", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, disposable, any type, monaural", "description": "Hearing aid, disposable, any type, monaural", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5262", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, disposable, any type, binaural", "description": "Hearing aid, disposable, any type, binaural", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5263", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ear mold/insert, not disposable, any type", "description": "Ear mold/insert, not disposable, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5264", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ear mold/insert, disposable, any type", "description": "Ear mold/insert, disposable, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5265", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Battery for use in hearing device", "description": "Battery for use in hearing device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5266", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid or assistive listening device/supplies/accessories, not otherwise specified", "description": "Hearing aid or assistive listening device/supplies/accessories, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5267", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, telephone amplifier, any type", "description": "Assistive listening device, telephone amplifier, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5268", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, alerting, any type", "description": "Assistive listening device, alerting, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5269", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, television amplifier, any type", "description": "Assistive listening device, television amplifier, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5270", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, television caption decoder", "description": "Assistive listening device, television caption decoder", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5271", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, tdd", "description": "Assistive listening device, tdd", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5272", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, for use with cochlear implant", "description": "Assistive listening device, for use with cochlear implant", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5273", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, not otherwise specified", "description": "Assistive listening device, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5274", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Ear impression, each", "description": "Ear impression, each", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5275", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal fm/dm system, monaural, (1 receiver, transmitter, microphone), any type", "description": "Assistive listening device, personal fm/dm system, monaural, (1 receiver, transmitter, microphone), any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5281", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal fm/dm system, binaural, (2 receivers, transmitter, microphone), any type", "description": "Assistive listening device, personal fm/dm system, binaural, (2 receivers, transmitter, microphone), any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5282", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal fm/dm neck, loop induction receiver", "description": "Assistive listening device, personal fm/dm neck, loop induction receiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5283", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal fm/dm, ear level receiver", "description": "Assistive listening device, personal fm/dm, ear level receiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5284", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal fm/dm, direct audio input receiver", "description": "Assistive listening device, personal fm/dm, direct audio input receiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5285", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal blue tooth fm/dm receiver", "description": "Assistive listening device, personal blue tooth fm/dm receiver", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5286", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal fm/dm receiver, not otherwise specified", "description": "Assistive listening device, personal fm/dm receiver, not otherwise specified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5287", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal fm/dm transmitter assistive listening device", "description": "Assistive listening device, personal fm/dm transmitter assistive listening device", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5288", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, personal fm/dm adapter/boot coupling device for receiver, any type", "description": "Assistive listening device, personal fm/dm adapter/boot coupling device for receiver, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5289", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Assistive listening device, transmitter microphone, any type", "description": "Assistive listening device, transmitter microphone, any type", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5290", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing aid, not otherwise classified", "description": "Hearing aid, not otherwise classified", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5298", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Hearing service, miscellaneous", "description": "Hearing service, miscellaneous", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5299", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Repair/modification of augmentative communicative system or device (excludes adaptive hearing aid)", "description": "Repair/modification of augmentative communicative system or device (excludes adaptive hearing aid)", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5336", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Speech screening", "description": "Speech screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5362", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Language screening", "description": "Language screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5363", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] }, { "name": "Dysphagia screening", "description": "Dysphagia screening", "negotiation_arrangement": "ffs", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "V5364", "negotiated_rates": [ { "provider_references": [ 1, 2, 3 ], "negotiated_prices": [ { "negotiated_type": "percentage", "negotiated_rate": 100.0, "expiration_date": "2026-12-31", "additional_information": "Pricing is {100.00}% of the charge. {2,6}", "billing_class": "professional", "setting": "outpatient", "service_code": [ "11" ] } ] } ] } ] }