January 2007 Medicare Bulletin - Tennessee Insert
Posted January 5, 2007
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Table of Contents
- 2007 Tennessee Medicare Clinical Social Worker Fee Schedule
- 2007 Tennessee Medicare Clinical Psychologist Fee Schedule
- Tennessee’s ASC Facility Adjusted Rate Effective 01/01/2007
- Tennessee– 2007 OPPS Payment Cap Amounts For The TC And Global Portion Of Imaging Services
- Tennessee Health Professional Shortage Areas
- Tennessee Mental Health Professional Shortage Areas
TopTennessee Mental Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
|
Tennessee Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
|
1 Classified as a HPSA, effective March 1, 2002.
2 No longer classified as a HPSA, effective March 1, 2002.
3 Classified as a HPSA, effective June 1, 2002.
4 Classified as a HPSA, effective February 1, 2004.
5
No longer classified as a HPSA, effective February 1, 2005
6Classified as a HPSA, effective September 12, 2006
7Classified as a HPSA, Effective August 8, 2006
8No longer classified as a HPSA. effective August 8, 2006
2007 Tennessee Ambulance Fee Schedule
| Code | Urban Rate | Rural Rate |
| A0425 | $6.25 | $6.25 |
| A0426 | $213.87 | $213.87 |
| A0427 | $338.63 | $338.63 |
| A0428 | $178.22 | $178.22 |
| A0429 | $285.16 | $285.16 |
| A0430 | $2,481.43 | $3,722.15 |
| A0431 | $2,885.03 | $4,327.55 |
| A0432 | $311.89 | $311.89 |
| A0433 | $490.12 | $490.12 |
| A0434 | $579.23 | $579.23 |
| A0435 | $7.49 | $11.24 |
| A0436 | $19.96 | $29.94 |
2007 Tennessee Medicare Clinical Social Worker Fee Schedule
| Procedure Code | Non Facility Fee | Facility Fee |
| 90801AJ | $103.99 | $93.97 |
| 90802AJ | $110.32 | $100.80 |
| * 90804AJ | $44.28 | $40.03 |
| * 90806AJ | $64.70 | $61.45 |
| * 90808AJ | $95.94 | $92.43 |
| * 90810AJ | $47.30 | $44.05 |
| * 90812AJ | $69.80 | $65.29 |
| * 90814AJ | $100.79 | $97.03 |
| * 90816AJ | $43.13 | $43.13 |
| * 90818AJ | $64.80 | $64.80 |
| * 90821AJ | $96.32 | $96.32 |
| * 90823AJ | $46.48 | $46.48 |
| * 90826AJ | $68.86 | $68.86 |
| * 90828AJ | $99.89 | $99.89 |
| 90845AJ | *$59.74 | $58.74 |
| *# 90846AJ | $63.13 | $62.63 |
| *# 90847AJ | $77.48 | $74.72 |
| *# 90849AJ | $22.43 | $21.18 |
| * 90853AJ | $21.75 | $20.75 |
| * 90857AJ | $24.14 | $22.39 |
| * 90880AJ | $79.91 | $72.41 |
| 96102AJ | $33.00 | $16.73 |
| 96103AJ | $25.70 | $17.18 |
| 96105AJ | $49.01 | $49.01 |
| 96110AJ | $7.69 | $7.69 |
| 96111AJ | $93.73 | $92.72 |
| 96119AJ | $45.90 | $21.36 |
| 96120AJ | $39.47 | $17.18 |
* The procedure code is subject to the 62.5% outpatient psychiatric payment limitation (i.e., the allowed amount is reduced to 62.5% of the allowable amount).
# The procedure code has a restricted coverage status. Documentation must be included in order to review for coverage.
© All Current Procedural Terminology (CPT) codes and descriptors are copyrighted by the American Medical Association.
2007 Tennessee Medicare Clinical Psychologist Fee Schedule
| Procedure Code | Non Facility Fee | Facility Fee |
| 90801AH | $138.65 | $125.29 |
| 90802AH | $147.09 | $134.40 |
| * 90804AH | $59.04 | $53.37 |
| * 90806AH | $86.27 | $81.93 |
| * 90808AH | $127.92 | $123.24 |
| * 90810AH | $63.07 | $58.73 |
| * 90812AH | $93.06 | $87.05 |
| * 90814AH | $134.38 | $129.37 |
| * 90816AH | $57.51 | $57.51 |
| * 90818AH | $86.40 | $86.40 |
| * 90821AH | $128.43 | $128.43 |
| * 90823AH | 61.97 | $$61.97 |
| * 90826AH | $91.81 | $91.81 |
| * 90828AH | $133.18 | $133.18 |
| * 90845AH | $79.65 | $78.32 |
| *# 90846AH | $84.17 | $83.50 |
| *# 90847AH | $103.30 | $99.63 |
| *# 90849AH | $29.90 | $28.24 |
| * 90853AH | $29.00 | $27.67 |
| * 90857AH | $32.19 | $29.85 |
| * 90880AH | $106.55 | $96.54 |
| 96101AH | $83.83 | $83.16 |
| 96102AH | $44.00 | $22.30 |
| 96103AH | $34.26 | $22.91 |
| 96105AH | $65.34 | $65.34 |
| 96110AH | $10.25 | $10.25 |
| 96111AH | $124.97 | $123.63 |
| 96116AH | $92.90 | $87.22 |
| 96118AH | $109.26 | $86.22 |
| 96119AH | $61.20 | $28.48 |
| 96120AH | $52.63 | $22.91 |
* The procedure code is subject to the 62.5% outpatient psychiatric payment limitation (i.e., the allowed amount is reduced to 62.5% of the allowable amount).
# The procedure code has a restricted coverage status. Documentation must be included in order to review for coverage.
© All Current Procedural Terminology (CPT) codes and descriptors are copyrighted by the American Medical Association
2007 Chiropractic Fee Schedule – Tennessee
| Code | PAR F/S | Non PAR F/S | Limiting Charge |
| 98940 | 23.07 | 21.92 | 25.21 |
| # 98940 | 19.40 | 18.43 | 21.19 |
| 98941 | 31.90 | 30.31 | 34.86 |
| # 98941 | 27.89 | 26.50 | 30.48 |
| 98942 | 42.05 | 39.95 | 45.94 |
| # 98942 | 37.71 | 35.82 | 41.19 |
| 98943 | NC | NC | NC |
# These amounts apply when service is performed in a facility setting.
Limiting charge applies to unassigned claims by non-participating providers.
NC indicates that the service is non-covered by Medicare.
© All Current Procedural Terminology (CPT) codes and descriptors are copyrighted by the American Medical Association.
Tennessee’s ASC Facility Adjusted Rate Effective 01/01/2007
The following fees are the Adjusted ASC payment rates for the areas within Tennessee. These amounts were developed by following the instructions to carriers for wage adjusting the standard ASC payment rates. These instructions are in the CMS Manual Systems, Pub 100-04, Medicare Claims Processing Manual, Chapter 14, Section 40.2 (the Internet Only Manuals can be accessed at: www.cms.hhs.gov/manuals/IOM/list.asp).
The standard ASC payment rates are found on the HCPCS ALL list on the CMS Web site at: www.cms.hhs.gov/apps/ama/license.asp?file=/ascpayment/downloads/07asc_hcpcs.zip .
Tennessee - 2007 OPPS Payment Cap Amounts For The TLC and Global Portion of Imaging Services
Tennessee– 2007 OPPS Payment Cap Amounts For The TC And Global Portion Of Imaging Services
