January 2008 Medicare Bulletin - North Carolina Insert
Posted January 4, 2008
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Table of Contents
- 2008 Chiropractic Fee Schedule – North Carolina
- 2008 North Carolina Medicare Clinical Psychologist Fee Schedule
- 2008 North Carolina Medicare Clinical Social Worker Fee Schedule
- 2008 North Carolina Ambulance Fee Schedule
- Mark your Calendars for the Upcoming North Carolina Medicare 101 & Medicare 102 Workshop Series
Top2008 Chiropractic Fee Schedule – North Carolina
| Code | PAR F/S | NON PAR F/S | LIMITING CHARGE |
| 98940 | 20.38 | 19.36 | 22.26 |
| # 98940 | 17.23 | 16.37 | 18.83 |
| 98941 | 28.21 | 26.80 | 30.82 |
| # 98941 | 24.44 | 23.22 | 26.70 |
| 98942 | 36.93 | 35.08 | 40.34 |
| # 98942 | 33.16 | 31.50 | 36.23 |
| 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 2007 by the American Medical Association.
2008 North Carolina Ambulance Fee Schedule
| CODE RATE | URBAN RATE | RURAL |
| A0425 | $6.42 | $ 6.42 |
| A0426 | $226.69 | $226.69 |
| A0427 | $358.92 | $358.92 |
| A0428 | $188.91 | $188.91 |
| A0429 | $302.25 | $302.25 |
| A0430 | $2,605.34 | $3,908.01 |
| A0431 | $3,029.80 | $4,543.62 |
| A0432 | $330.59 | $330.59 |
| A0433 | $519.50 | $519.50 |
| A0434 | $613.95 | $613.95 |
| A0435 | $7.69 | $11.53 |
| A0436 | $20.50 | $30.75 |
2008 North Carolina Medicare Clinical Psychologist Fee Schedule
| Procedure Code | Non-Facility Fee | Facility Fee |
| 90801AH | $124.90 | $106.98 |
| 90802AH | $132.33 | $115.35 |
| * 90804AH | $52.43 | $45.51 |
| * 90806AH | $74.35 | $69.63 |
| * 90808AH | $109.79 | $104.76 |
| * 90810AH | $55.62 | $49.65 |
| * 90812AH | $80.79 | $73.55 |
| * 90814AH | $115.60 | $109.31 |
| * 90816AH | $49.33 | $49.33 |
| * 90818AH | $73.44 | $73.44 |
| * 90821AH | $108.90 | $108.90 |
| * 90823AH | $53.27 | $53.27 |
| * 90826AH | $78.24 | $78.24 |
| * 90828AH | $113.47 | $113.47 |
| * 90845AH | $68.27 | $66.70 |
| *# 90846AH | $72.41 | $71.15 |
| *# 90847AH | $90.17 | $85.45 |
| *# 90849AH | $27.08 | $24.57 |
| * 90853AH | $25.61 | $24.04 |
| * 90857AH | $28.80 | $25.66 |
| * 90880AH | $90.45 | $81.96 |
| 96101AH | $71.10 | $70.47 |
| 96102AH | $42.46 | $18.87 |
| 96103AH | $32.94 | $19.73 |
| 96105AH | $57.63 | $57.63 |
| 96110AH | $9.52 | $9.52 |
| 96111AH | $107.05 | $105.16 |
| 96116AH | $79.55 | $74.52 |
| 96118AH | $93.07 | $73.26 |
| 96119AH | $59.69 | $24.15 |
| 96120AH | $53.38 | $19.42 |
| 96125AH | $77.00 | $64.73 |
* 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 2007 by the American Medical Association.
2008 North Carolina Medicare Clinical Social Worker Fee Schedule
| Procedure Code | Non-Facility Fee | Facility Fee |
| 90801AJ | $93.68 | $80.24 |
| 90802AJ | $99.25 | $86.51 |
| * 90804AJ | $39.32 | $34.13 |
| * 90806AJ | $55.76 | $52.22 |
| * 90808AJ | $82.34 | $78.57 |
| * 90810AJ | $41.72 | $37.24 |
| * 90812AJ | $60.59 | $55.16 |
| * 90814AJ | $86.70 | $81.98 |
| * 90816AJ | $37.00 | $37.00 |
| * 90818AJ | $55.08 | $55.08 |
| * 90821AJ | $81.68 | $81.68 |
| * 90823AJ | $39.95 | $39.95 |
| * 90826AJ | $58.68 | $58.68 |
| * 90828AJ | $85.10 | $85.10 |
| * 90845AJ | $51.20 | $50.03 |
| *# 90846AJ | $54.31 | $53.36 |
| *# 90847AJ | $67.63 | $64.09 |
| *# 90849AJ | $20.31 | $18.43 |
| * 90853AJ | $19.21 | $18.03 |
| * 90857AJ | $21.60 | $19.25 |
| * 90880AJ | $67.84 | $61.47 |
| 96102AJ | $31.85 | $14.15 |
| 96103AJ | $24.71 | $14.80 |
| 96105AJ | $43.22 | $43.22 |
| 96110AJ | $7.14 | $7.14 |
| 96111AJ | $80.29 | $78.87 |
| 96119AJ | $44.77 | $18.11 |
| 96120AJ | $40.04 | $14.57 |
| 96125AJ | $57.75 | $48.55 |
* 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.
Mark your Calendars for the Upcoming North Carolina Medicare 101 & Medicare 102 Workshop Series
The North Carolina Provider Outreach and Education team at CIGNA Government Services is pleased to present the upcoming 2008 Medicare 101 and Medicare 102 Workshop Series.
Medicare 101 Workshops are designed to meet the needs of new Medicare providers and billing staff, generally those with less than 2 years of experience in the Medicare Program. Topics covered in the Medicare 101 workshops will include:
- Overview of Medicare
- CPT Procedure Coding
- Modifiers
- ICD-9 Diagnosis Coding
- Medicare Resources
- Billing and Reimbursement
- Advance Beneficiary Notice (ABN)
- Appeals Process
Medicare 101 Workshops are currently scheduled in Asheville, Greenville, and Greensboro, North Carolina in January 2008.
Medicare 102 Workshops are designed to meet the needs of more experienced Medicare providers and billing staff, and are also recommended for new providers as a companion course to the Medicare 101 workshop. Topics covered in the Medicare 102 workshops will include:
- Local Coverage Determinations (LCDs)
- Evaluation & Management (E/M) Services
- Medicare Secondary Payer (MSP)
- Overpayment/ Recovery
- Comprehensive Error Rate Testing (CERT)
- Provider Enrollment
- Incident To Billing Guidelines
Medicare 102 Workshops are currently scheduled in Asheville, Greenville, and Greensboro, North Carolina in February 2008.
Please note, Durable Medical Equipment (DME) and specialty-specific billing instructions will not be included in these workshop agendas.
