MARCH 27, 2001

Agenda Item No. 16



Introduced by the Human Services and Finance Committees of the:



INGHAM COUNTY BOARD OF COMMISSIONERS



RESOLUTION TO ADJUST THE HEALTH DEPARTMENT'S CLINICAL FEE SCHEDULE



RESOLUTION #01-89



WHEREAS, the Board of Commissioners has the authority to establish fees for services provided by the Health Department, such authority being established in the Public Health Code; and



WHEREAS, the Board of Commissioners has established a number of fee schedules for services provided by the Health Department; and

WHEREAS, the Board of Commissioners has established a fee schedule for clinical services; and



WHEREAS, the Department attempts to maintain a fee schedule that assures the maximum collection of fees from first and third parties and the Department charges for clinical services on a sliding fee schedule, based on the patient's ability to pay, with most persons falling in the no pay range; and



WHEREAS, the Health Officer has recommended that a number of the fees in the Clinical Fee Schedule be adjusted to reflect the increase in costs and the increase in the Medicaid fee screen for services.



THEREFORE BE IT RESOLVED, that the Ingham County Board of Commissioners adopts a new Clinical Fee Schedule, which is attached to the resolution.



BE IT FURTHER RESOLVED, that the new Clinical Fee Schedule will become effective on April 1, 2001.



HUMAN SERVICES COMMITTEE: Yeas: Czarnecki, Dedden, Hertel, Celentino

Nays: Severino Absent: None Approved 3/19/01



FINANCE: Yeas: Czarnecki, Hertel, Schafer, Minter, Swope, Krause

Nays: None Absent: Lynch Approved 3/21/01

INGHAM COUNTY HEALTH DEPARTMENT CLINICAL SERVICES FEE SCHEDULE

Summary of Changes
Procedure Current Proposed
Code Explanation of Services Fee Fee
Office Visits - New Patients
99205 New - Level 5-Comprehensive-High Complexity $70.00 $110.00
99204 New - Level 4-Comprehensive-Moderate Complexity $55.00 $90.00
99203 New - Level 3-Detailed-Low Complexity $40.00 $65.00
99202 New - Level 2-Expanded Focus $40.00 $45.00
99385 New - Well Child - 18 + years $60.00 $70.00
99384 New - Well Child - 12 through 17 years $60.00 $70.00
99383 New - Well Child - 5 through 11 years $60.00 $70.00
99382 New - Well Child - 1 through 4 years $60.00 $70.00
99381 New - Well Child - under 1 year $60.00 $70.00
Office Visits - Established Patients
99215 Revisit - Level 5-Comprehensive-High Complexity $50.00 $75.00
99214 Revisit - Level 4-Comprehensive-Moderate Complexity $35.00 $50.00
99213 Revisit - Level 3-Detailed-Low Complexity $25.00 $35.00
99395 Revisit - Well Child - 18 + years $50.00 $60.00
99394 Revisit - Well Child - 12 through 17 years $50.00 $60.00
99393 Revisit - Well Child - 5 through 11 years $50.00 $60.00
99392 Revisit - Well Child - 1 through 4 years $50.00 $60.00
99391 Revisit - Well Child - under 1 year $50.00 $60.00
Other Office Visits
Marriage License Consults (Single) $15.00
Marriage License Consults (Double) $20.00
Laboratory
Clinitest $5.00
Diastix $5.00
83655 Lead $15.00
86308 Mono Spot $5.00
85651 Sed. Rate $5.00
86403 Strep Screen $5.00 $6.00
80001 K+ $15.00
Procedures
Allergy Injection $5.00
11100 Biopsy, skin - single lesion $55.00
11101 Biopsy, skin - each additional lesion $25.00
54510 Cautery (Chem.) - Cervix $10.00 $115.00
57055 Cautery (Elec.) - Destruction lesion $10.00 $60.00
57452 Colposcopy $60.00
57454 Colposcopy with biopsy and/or endocervical curettage $70.00
11720 Debridement of Nail(s) by any method; one to five $20.00
56501 Destruction of lesion(s), vulva, simple, any method $90.00
11710 Evacuation of subungual hematoma $25.00
11400 Excision, benign lesion, except skin tag, on trunk, arms $80.00
or legs: lesion diameter 0.5 cm or less













INGHAM COUNTY HEALTH DEPARTMENT CLINICAL SERVICES FEE SCHEDULE
Summary of Changes
Procedure Current Proposed
Code Explanation of Services Fee Fee
11420 Excision, benign lesion, except skin tag, on scalp, $70.00
neck, hands, feet, genitalia; lesion dia. .5 cm or less
11421 lesion diameter .6 to 1.0 cm $90.00
11422 lesion diameter 1.1 to 2.0 cm $100.00
11423 lesion diameter 2.1 to 3.0 cm $115.00
11424 lesion diameter 3.1 to 4.0 cm $130.00
11426 lesion diameter over 4.0 cm $175.00
11450 Excision for hidradenitis; axillary; with simple or $95.00
intermediate repair
11470 Excision for hidradenitis; perianal, perineal, or umbilical; $110.00
with simple or intermediate repair
57500 Excision, cervix, biopsy or local excision, single or $55.00
multiple
57505 Excision, endocervical cutterage $70.00
58100 Excision, endometrial sampling $45.00
57100 Excision, biopsy of vaginal mucosa, simple $55.00
56605 Excision, biopsy of vulva or perineum, one lesion $65.00
56606 each separate additional lesion $50.00
57160 Fitting and insertion of pessary support device $50.00
10060 Incision and drainage of abcess, simple, or single $20.00 $60.00
56420 Incision and drainage of Bartholin's gland abcess $60.00
98925 OMT - quantity 1-2 $20.00
98926 OMT - quantity 3-4 $25.00
98927 OMT - quantity 5-6 $35.00
11200 Removal of skin tags, any area, up to and including $45.00
15 lesions
17000 Wart Removal/Destruction of Lesions = 1 $15.00 $40.00
17003 Wart Removal/Destruction of Lesions = 2-14 $15.00 $10.00
86580 TB Skin Test $5.00 $7.00
76830 Ultrasound, diagnostic; echography, transvaginal $60.00
36415 Venipuncture, routine or finger/heel/ear stick for $5.00
collection of specimen(s)
Injections
J1100 Decadron $5.00 $6.00
J3301 Kanalog -10, -40 $5.00 $8.00
J0696 Rocephin Injection 250 mg (each 250 mg. dosage) $5.00 $13.00
J2920 Solu-Medrol $5.00 $10.00
J3420 Vitamin B-12 $5.00 $7.00
LEAD POISONING INVESTIGATION FEES
300027 Nursing Assessment/Education $75.00 $85.00








INGHAM COUNTY HEALTH DEPARTMENT CLINICAL SERVICES FEE SCHEDULE
Summary of Changes
Procedure Current Proposed
Code Explanation of Services Fee Fee
MATERNAL AND INFANT SUPPORT SERVICES
First Visit/Assessment $80.00
Z0001 Clinic $80.00
Z0004/Z0020 Home $105.00
Revisit $70.00
Z0002/Z0022 Clinic $75.00
Z0003/Z0021 Home $95.00
PRENATAL FEES
59025 Fetal non-stress test $25.00
76818 Fetal biophysical profile, with non-stress testing $65.00
76815 Diagnostic Ultrasound, OB, limited $55.00
59430 Postpartum care only $85.00
FAMILY PLANNING
Office Visits
89005 New Physical Exam $45.00 $50.00
89027 Annual Physical $32.00 $35.00
89025 Medical Revisit $14.00 $15.00
89020 Counseling Visit $8.50 $10.00
Laboratory
88534 VDRL $3.50 $5.00
Contraceptive Supplies
89815 IUD $90.00 $125.00
89816 Sponge $6.00 $10.00
Pharmaceutical Supplies
Gynazole - 1 $ 20.00
89867 Rocephin Injection 250 mg $10.00 $13.00
89868 Terazol Cream $7.00 $14.00






INGHAM COUNTY HEALTH DEPARTMENT CLINICAL SERVICES FEE SCHEDULE

Procedure
Code Explanation of Services FEE
Office Visits - New Patients
99205 New - Level 5-Comprehensive-High Complexity $110.00
99204 New - Level 4-Comprehensive-Moderate Complexity $90.00
99203 New - Level 3-Detailed-Low Complexity $65.00
99202 New - Level 2-Expanded Focus $45.00
99201 New - Level 1-Problem Focused $40.00
99385 New - Well Child - 18 + years $70.00
99384 New - Well Child - 12 through 17 years $70.00
99383 New - Well Child - 5 through 11 years $70.00
99382 New - Well Child - 1 through 4 years $70.00
99381 New - Well Child - under 1 year $70.00
Office Visits - Extablished Patients
99215 Revisit - Level 5-Comprehensive-High Complexity $75.00
99214 Revisit - Level 4-Comprehensive-Moderate Complexity $50.00
99213 Revisit - Level 3-Detailed-Low Complexity $35.00
99212 Revisit - Level 2-Expanded Focus $25.00
99211 Revisit - Level 1-Problem Focused $25.00
99395 Revisit - Well Child - 18 + years $60.00
99394 Revisit - Well Child - 12 through 17 years $60.00
99393 Revisit - Well Child - 5 through 11 years $60.00
99392 Revisit - Well Child - 1 through 4 years $60.00
99391 Revisit - Well Child - under 1 year $60.00
Other Office Visits
Agency PEs/County Pre-Employ PE's $30.00
Insurance PEs $45.00
Immigration PE's $70.00
Employment/School PE's $40.00
Travel Consultation $25.00
Lab/Injection Only $5.00
Laboratory
82947 Blood sugar $5.00
87210 Hanging drop $5.00
83655 Lead $15.00
85018 Hematocrit/Hemoglobin $5.00
82270 Occult Blood $5.00
86403 Strep Screen $6.00
84703 UCG $6.00
81002 Urinalysis $3.00
81000 UA with Micro $3.00
Procedures
92551 Audiogram -Screening $20.00
92552 Audiogram -Threshold $20.00
11100 Biopsy, skin - single lesion $55.00
11101 Biopsy, skin - each additional lesion $25.00











INGHAM COUNTY HEALTH DEPARTMENT CLINICAL SERVICES FEE SCHEDULE

Procedure
Code Explanation of Services FEE
57510 Cautery (Chem.) - Cervix $115.00
54055 Cautery (Elec.) - Destruction lesion $60.00
57452 Colposcopy $60.00
57454 Colposcopy with biopsy and/or endocervical curettage $70.00
11720 Debridement of Nail(s) by any method; one to five $20.00
56501 Destruction of lesion(s), vulva, simple, any method $90.00
96110 Denver Development Test $35.00
69210 Ear Irrigation $10.00
93000 EKG $30.00
11710 Evacuation of subungual hematoma $25.00
11400 Excision, benign lesion, except skin tag, on trunk, arms $80.00
or legs: lesion diameter 0.5 cm or less
11420 Excision, benign lesion, except skin tag, on scalp, $70.00
neck, hands, feet, genitalia; lesion dia. .5 cm or less
11421 lesion diameter .6 to 1.0 cm $90.00
11422 lesion diameter 1.1 to 2.0 cm $100.00
11423 lesion diameter 2.1 to 3.0 cm $115.00
11424 lesion diameter 3.1 to 4.0 cm $130.00
11426 lesion diameter over 4.0 cm $175.00
11450 Excision for hidradenitis; axillary; with simple or $95.00
intermediate repair
11470 Excision for hidradenitis; perianal, perineal, or umbilical; $110.00
with simple or intermediate repair
57500 Excision, cervix, biopsy or local excision, single or $55.00
multiple
57505 Excision, endocervical cutterage $70.00
58100 Excision, endometrial sampling $45.00
57100 Excision, biopsy of vaginal mucosa, simple $55.00
56605 Excision, biopsy of vulva or perineum, one lesion $65.00
56606 each separate additional lesion $50.00
57160 Fitting and insertion of pessary support device $50.00
10060 Incision and drainage of abcess, simple, or single $60.00
56420 Incision and drainage of Bartholin's gland abcess $60.00
92567 Impedance Tympanometry $20.00
98925 OMT - quantity 1-2 $20.00
98926 OMT - quantity 3-4 $25.00
98927 OMT - quantity 5-6 $35.00
94640 Pulmo-Aid Nebulizer $25.00
11200 Removal of skin tags, any area, up to and including $45.00
15 lesions
X0055 Suture Removal $15.00
17000 Wart Removal/Destruction of Lesions = 1 $40.00
17003 Wart Removal/Destruction of Lesions = 2-14 $10.00
86580 TB Skin Test $7.00
Dressing $10.00
76830 Ultrasound, diagnostic; echography, transvaginal $60.00
36415 Venipucture, routine or finger/heel/ear stick for $5.00
collection of specimen(s)











INGHAM COUNTY HEALTH DEPARTMENT CLINICAL SERVICES FEE SCHEDULE

Procedure
Code Explanation of Services FEE
Injections
J1100 Decadron $6.00
J3301 Kanalog -10, -40 $8.00
J0696 Rocephin Injection 250 mg (each 250 mg. dosage) $13.00
J2920 Solu-Medrol $10.00
J3420 Vitamin B-12 $7.00
LEAD POISONING INVESTIGATION FEES
300025 Initial Environment Assessment $100.00
300026 Follow-Up Environmental Visit $100.00
300027 Nursing Assessment/Education $85.00
MATERNAL AND INFANT SUPPORT SERVICES
First Visit/Assessment
Z0001 Clinic $80.00
Z0004/Z0020 Home $105.00
Revisit
Z0002/Z0022 Clinic $75.00
Z0003/Z0021 Home $95.00
Z0005 Education $40.00
PRENATAL FEES
X4855 First Visit $75.00
X4855 Revisit $75.00
X4854 Package Price $700.00
59025 Fetal non-stress test $25.00
76818 Fetal biophysical profile, with non-stress testing $65.00
76815 Diagnostic Ultrasound, OB, limited $55.00
59430 Postpartum care only $85.00
FAMILY PLANNING
Office Visits
89005 New Physical Exam $50.00
89027 Annual Physical $35.00
89025 Medical Revisit $15.00
89020 Counseling Visit $10.00
89049 Lab Only $6.00
Procedures
84710 Diaphragm Fit $14.00
89028 IUD Insertion $60.00
89050 IUD Removal $14.00
89031 Norplant Insertion $150.00
89032 Norplant Removal $150.00













INGHAM COUNTY HEALTH DEPARTMENT CLINICAL SERVICES FEE SCHEDULE

Procedure
Code Explanation of Services FEE
Laboratory
88368 Hematocrit $5.00
88534 VDRL $5.00
88701 Urinalysis $3.00
88703 Urine Micro $3.00
88775 UCG/ICON $6.00
88881 Hanging drop/Micro $5.00
88920 Cytology/Pap $8.00
Contraceptive Supplies
89800 Birth Control Pills $6.50
89810 Diaphragm $10.00
89811 Condoms $0.60
89812 Foam/Jelly/Cream $4.50
89815 IUD $125.00
89817 Norplant $400.00
Vaginal Contraceptive Film $1.80
89818 Depo Provera $30.00
89816 Sponge $10.00
Pharmaceutical Supplies
89855 Amoxicillin, 250 mg. $5.00
89856 Amoxicillin, 500 mg. $5.00
89851 Ampicillin, 250 mg. $5.00
89852 Ampicillin, 500 mg. $5.00
89858 Bactrim $5.00
89860 Erythromycin, 250 mg. $5.00
89861 Erythromycin, 500 mg. $7.00
89825 Floxin (single dose) $5.00
Floxin (14 day) $45.00
89820 Flagyl (Metronidzaole) $7.00
Gantricin $10.00
Gynazole - 1 $20.00
89862 Mycelex G Cream $15.00
89864 Keflex 250 mg $7.00
89865 Keflex 500 mg $7.00
Monistat $7.00
89866 Macrodantin $40.00
89859 Probenecid 500 mg $5.00
89867 Rocephin Injection 250 mg $11.00
Suprax $5.00
89868 Terazol Cream $14.00
89850 Tetracycline 250 mg $3.00
89854 Tetracycline 500 mg $3.00
89869 Vibramycin (Doxycline) $5.00