Managed Physical Network, Inc.

Transcription

1 MPN DC FEE SCHEDULE EVALUATION AND MANAGEMENT New Patient Exam; Problem Focused $ New Patient Exam; Expanded $ New Patient Exam; Detailed $ New Patient Exam; Comprehensive $ Established Patient Eval; Expanded $ Established Patient Eval; Detailed $45.00 CHIROPRACTIC MANIPULATIVE THERAPY Spinal Manipulation (regions one to two) $ Spinal Manipulation (regions three to four) $ Spinal Manipulation (regions five) $39.00 MODALITIES Modalities are reimbursed at a per diem rate CPT DESCRIPTION G0281 G0282 G0283 Electrical Stimulation, unattended, 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. Electrical Stimulation, unattended, one or more areas, for wound care other than described in G0281 Electrical Stimulation, unattended, to one or more areas for indication(s) ZONE 2 $16.00 other than wound care, as part of a therapy plan of care Traction, mechanical Whirlpool Diathermy Electrical stimulation, requiring direct one on one contact Iontophoresis, requiring direct one on one contact Ultrasound, requiring direct one on one contact PROCEDURES Procedures are reimbursed individually, each 15 minutes Therapeutic exercise $ Neuromuscular reeducation $ Massage, including effleurage, petrissage, and/or tapotement $ Manual therapy techniques (e.g., mobilization, manipulation, manual $16.00 lymphatic drainage, manual traction), one or more regions Therapeutic/dynamic activities requiring direct one on one contact $ Cognitive Therapy $ Self care/home management training requiring direct one on one contact $16.00 Rev 6/18/ RLM 1 of 5

2 Global Fees (Technical and Professional Component) Ribs; unilateral, 2 views $ Ribs; bilateral, 3 views $ Sternoclavicular joints; minimum of 3 views $ Spine; entire survey study, AP + LAT $ Spine; single view $ Cervical; AP + LAT $ Cervical; complete, minimum of 4 views $ Cervical; complete plus flex/ext $ Thoracolumbar; standing (scoliosis) $ Thoracic; AP + LAT $ Thoracic; AP + LAT, plus swimmer s view $ Thoracic; AP + LAT plus obliques, minimum of 4 views $ Thoracolumbar; AP + LAT $ Scoliosis study; supine & erect studies $ Lumbosacral; AP + LAT $ Lumbosacral; complete, with oblique views $ Lumbosacral; complete; plus bending views $ Lumbosacral; minimum of 4 bending views $ Pelvis; AP only $ Pelvis; complete, minimum of 3 views $ Sacroiliac joints; less than 3 views $ Sacroiliac joints; minimum of 3 views $ Sacrum and coccyx; minimum of 2 views $ Clavicle; complete $ Scapula; complete $ Shoulder; one view $ Shoulder; complete $ Acro-clavicular joints; bilateral $ Humerus; minimum of 2 views (inc. one joint) $39.00 Rev 6/18/ RLM 2 of 5

3 Global Fees (Technical and Professional Component) Continued Elbow; AP + LAT $ Elbow; minimum of 3 views $ Forearm; AP + LAT (inc. One joint) $ Wrist; AP + LAT $ Wrist; complete (minimum of 3 views) $ Hand; 2 views $ Hand; minimum 3 views $ Finger(s); minimum of 2 views $ Hip; unilateral, single view $ Hip; complete, minimum of 2 views $ Hip; bilateral, minimum of 2 views inc. AP pelvis $ Femur; AP + LAT, including one joint $ Knee; AP + LAT $ Knee; AP + LAT t, with oblique(s) $ Knee; complete, (minimum 4 views) $ Both knees; standing, anteroposterior $ Tibia and fibula; AP + LAT, including one joint $ Ankle; AP + LAT $ Ankle; complete $ Foot; 2 views $ Foot; complete, minimum of 3 views $ Os calcis (heel); minimum, of 2 views $ Toe(s); minimum of 2 views $29.00 Rev 6/18/ RLM 3 of 5

4 (Professional Component) Reimbursable when films are taken off site and not previously read Reimbursement is factored as a percentage of global reimbursement Ribs; unilateral, 2 views 40% Ribs; bilateral, 3 views 35% Sternoclavicular joints; minimum of 3 views 30% PC - Spine; entire survey study, AP + lat 40% PC - Spine: single view 35% PC - Cervical; AP + LAT 35% PC - Cervical; complete, minimum of 4 views 35% PC - Cervical; complete plus flex/ext 30% PC - Thoracolumbar; standing (scoliosis) 40% PC - Thoracic; AP + LAT 35% PC - Thoracic; AP + LAT, and swimmer s view 30% PC - Thoracic; AP + LAT and obliques, minimum of 4 views 25% PC - Thoracolumbar; AP + LAT 30% PC - Scoliosis study; supine & erect studies 40% PC - Lumbosacral; AP + LAT 30% PC - Lumbosacral; complete, with obliques 35% PC - Lumbosacral; complete; plus bending views 30% PC - Lumbosacral; minimum of 4 bending views 25% PC - Pelvis; AP only 30% PC - Pelvis; complete, minimum of 3 views 30% PC - Sacroiliac joints; less than 3 views 30% PC - Sacroiliac joints; 3 or more views 30% PC - Sacrum and coccyx; minimum of 2 views 30% PC - Clavicle; complete 30% PC - Scapula; complete 30% PC - Shoulder; one view 30% PC - Shoulder; complete 30% PC - Acro-clavicular joints; bilateral 30% PC - Humerus; minimum of 2 views (inc.one joint) 30% Rev 6/18/ RLM 4 of 5

5 (Professional Component) - Continued Reimbursable when films are taken off site and not previously read Reimbursement is factored as a percentage of global reimbursement PC Elbow; AP + LAT 30% PC Elbow; minimum of 3 views 30% PC Forearm; AP + LAT (inc. one joint) 30% PC Wrist; AP + LAT 30% PC Wrist; complete (minimum of 3 views) 30% PC Hand; 2 views 30% PC Hand; minimum of 3 views 30% PC Finger(s); minimum of 2 views 30% PC Hip; unilateral, single view 35% PC Hip; complete, minimum of 2 views 35% PC Hip; bilateral, minimum of 2 views inc. pelvis 35% PC Femur; AP + LAT, including one joint 30% PC Knee; AP + LAT 30% PC Knee; AP + LAT, with oblique(s) 30% PC Knee; complete (minimum of 4 views) 35% PC Both knees; standing, anteroposterior 35% PC Tibia and fibula; AP + LAT, inc. one joint 30% PC Ankle; AP + LAT 30% PC Ankle; complete 30% PC Foot; 2 views 30% PC Foot; complete, minimum of 3 views 30% PC Os calcis (heel); minimum of 2 views 35% PC Toe(s); minimum of 2 views 30% Rev 6/18/ RLM 5 of 5