92004 each eval $ VISF VISION EVALUATION FUNCTIONAL each eval $50.00 SPCH

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Junior Barrett
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Services Taxonomy ATTENTION: When these CPT s are entered in the billing portal, a descriptor will show that will not be familiar to you or make much sense.

1 Services Taxonomy ATTENTION: When these CPT s are entered in the billing portal, a descriptor will show that will not be familiar to you or make much sense. Please do not pay attention to these descriptors. If you have entered the correct CPT code and applicable modifiers, you will bill for the correct service associated with the CPT code for Early Steps. FORMER CPT SCTT SERVICE COORDINATOR TRAVEL A0160 CASE NON-TCM CASE MANAGEMENT T1016 TCM TARGETED CASE MANAGEMENT T1017TL (New Patient) eval $ VISF VISION EVALUATION FUNCTIONAL eval $50.00 SPCH EVALUATION BY LICENSED SPEECH eval $48.50 PURE TONE IOMETRY -AIR ONLY procedure $11.86 PURE TONE IOMETRY AIR & BONE procedure $15.25 SPEECH THRESHOLD (DETECTION) procedure $8.28 COMPREHENSIVE IOMETRY THRESHOLD EVALUATION & SPEECH RECOGNITION procedure $26.06 TYPMANOMETRY (IMPEDANCE TESTING) procedure $10.38 ACOUSTIC REFLEX TESTING (MIDDLE EAR MUSCLE REFLEX) procedure $8.10 VISUAL REINFORCEMENT IOMETRY procedure $21.08 CONDITIONED PLAY IOMETRY procedure $22.96 ITORY EVOKED RESPONSE (DIAGNOSTIC) procedure $51.76 ITORY EVOKED RESPONSE (SCREEN) procedure $30.49 OTOACOUSTIC EMISSIONS (LIMITED) procedure $27.19 OTOACOUSTIC EMISSIONS (COMPREHENSIVE) procedure $30.31 AACIS EVALUATION BY LICENSED SPEECH eval $97.50 EVAL DEVELOPMENTAL EVALUATION ADMINISTERED BY A LICENSED OR NON-LICENSED INTERVENTION OF 5

2 BEHV PSTH PSTF OCTH OCTF BEHAVIORAL ASSESSMENT PERFOR BY A LICENSED OR NON- LICENSED BEHAVIOR SPECIALIST INITIAL EVALUATION BY LICENSED FOLLOW-UP EVALUATION BY LICENSED INITIAL EVALUATION BY LICENSED FOLLOW-UP EVALUATION BY LICENSED CPT $ eval $ eval $ eval $ eval $48.50 ASTE ASSISTIVE TECHNOLOGY EVALUATION eval $48.50 NUTR NUTRITIONAL EVALUATION, INITIAL ( ) NUTR NUTRITIONAL EVALUATION, FOLLOW UP ( ) OUTPATIENT VISIT, NEW PATIENT, visit $25.96 OUTPATIENT VISIT, NEW PATIENT, visit $27.22 OUTPATIENT VISIT, NEW PATIENT, visit $40.50 OUTPATIENT VISIT, NEW PATIENT, visit $57.27 OUTPATIENT VISIT, NEW PATIENT, visit $72.78 PATIENT, visit $10.38 PATIENT, visit $18.17 PATIENT, visit $22.14 PATIENT, visit $34.50 PATIENT, visit $50.15 PSYCHIATRIC DIAGNOSTIC INTERVIEW 90801HA visit $88.64 IOLOGY SERVICES BIAURAL ( for Non-Medicaid) visit $50.00 AACRS EVALUATION (AAC) RE-EVALUATION 92597GN eval $50.00 BY LICENSED SPEECH - LANGUAGE PATHOLOGIST AACIO 92597GO eval $97.50 EVALUATION BY LICENSED AACIP EVALUATION BY LICENSED PHYSICAL 92597GP eval $ OF 5

3 WHEELP WHEELO BEHV WHEELCHAIR EVALUATION/ FITTING BY LICENSED WHEELCHAIR EVALUATION/ FITTING BY LICENSED OCCUPATIONAL (SIMPLE) (LOW COMPLEXITY) (MODERATE COMPLEXITY) COMPREHENSIVE BEHAVIORAL HEALTH ASSESSMENT BY A NON- PHYSICIAN MASTERS DEGREE CPT 97001TG eval $ TG eval $ SC eval $ SC eval $ SC eval $57.27 H0031HO $ NURS NURSING ASSESSMENT T1001 $50.00 UNSPECIFIED OFFICE VISIT T1015 visit $ SCREEN SCREENING T1023 screen $50.00 EXIT EXIT ASSESSMENT T1024 SPEECH- SPEECH - INFANT TODDLER DEVELOPMENTAL SPECIALIST INTERVENTION T1024GN T1024GN T1024GO T1024GO T1024GP T1024GP T1024HN T1024TL INTERVENTION T1024TL NON-ICAID T OF 5

4 INFANT TODDLER DEVELOPMENTAL SPECIALIST NON-ICAID CPT T1024 T1024 ASSESSMENT FOR HEARING AID V5010 $45.00 DISPENSING FEE PER HEARING AID V5090 aid $ UNSPECIFIED IOLOGICAL EVALUATION PROCEDURES V5299 series $60.00 INDIVIDUAL PSYCHOTHERAPY, MINUTES $25.00 SPEECH/LANGUAGE THERAPY SESSION BY LICENSED SPEECH AACFIT PHY OCCT GROUP SPEECH/LANGUAGE THERAPY SESSION PER CHILD EVALUATION (AAC) FITTING, ADJUSTMENT, TRAINING VISIT EVALUATION OF ITORY REHABILITATION STATUS ITORY REHABILITATION PRELINGUAL HEARING LOSS ITORY REHABILITATION POSTLINGUAL HEARING LOSS HEALTH AND BEHAVIOR INTERVENTION SESSION BY LICENSED SESSION BY LICENSED OCCUPATIONAL $ eval $ eval $ visit $ visit $ CONIF CONSULTATION, FACE TO FACE PHY OCCT SPEECH/LANGUAGE THERAPY SESSION BY SPEECH - LANGUAGE PATHOLOGY ASSISTANT IOLOGY SERVICE MONAURAL (for Non-Medicaid) SESSION BY PHYSICAL THERAPY ASSISTANT SESSION BY OCCUPATIONAL THERAPY ASSISTANT 92507HM $ visit $ HM 97530HM CONIP CONSULTATION, PHONE 99368TL PROVIDER TRAVEL FOR INITIAL EVALUATION PER MINUTE PROVIDER TRAVEL FOR INITIAL EVALUATION $10 PER CHILD A0080 minute $0.50 A0090 day $ OF 5

5 TRAV TRAV PROVIDER TRAVEL TO NATURAL ENVIRONMENT PER MINUTE PROVIDER TRAVEL TO NATURAL ENVIRONMENT $10 PER CHILD CPT COUN INDIVIDUAL/FAMILY THERAPY H2019HR RSPT RESPITE T1005 INTR INTERPRETER T1013 EIGF EIGF INTERVENTION INDIVIDUAL SESSION BY NONICAID INTERVENTION INDIVIDUAL SESSION BY INTERVENTION INTERVENTION GROUP SESSION BY NONICAID INTERVENTION GROUP SESSION BY INTERVENTION A0160 minute $0.50 A0170 day $10.00 T1027SC T1027SC T1027TT T1027TT SC SC $18.33 ASST ASSISTIVE TECHNOLOGY T1999 device $1, COIFP IFSP CONSULTATION,, T2024GQ TL BY PHONE COIFF IFSP CONSULTATION,, T2024TL FACE TO FACE ECE CHILDHOOD EDUCATION T2027 $3.13 SENS HEARING AID REPAIR BY MANUFACTURER V5014 device $ SENS HEARING AID REPAIR IN-OFFICE V5014 visit $15.00 SENS IN EAR HEARING AID UP TO $500 PER AID V5050SC device $ SENS EARMOLD V5264 device $18.00 SENS FM RECEIVER HEARING AID V5298 device $1, SENS SENSORY AID INSURANCE PER EAR V5299HA device $65.00 SENS HEARING AID - ANALOG/DIGITAL V5050 device $ OF 5

PROCEDURE CODES. The following chart lists the codes most commonly billed by EPSDT Health and IDEA-Related Services providers:

PROCEDURE CODES. The following chart lists the codes most commonly billed by EPSDT Health and IDEA-Related Services providers: PROCEDURE CODES Louisiana Medicaid follows the current American Medical Association s Current Procedural Terminology (CPT) coding and guidelines. If nationally approved changes occur to CPT codes at a