mete ajou 1 mas 2025
Swen konplè rekonèt ke aspè finansye nan swen ou a ka konfizyon. Angajman nou se pou nou transparan ke posib, epi pou nou ba ou enfòmasyon pou pran desizyon sou swen sante ou.
Swen konplè ankouraje pasyan ki pwograme pou sèvis oswa pwosedi yo kontakte yon Lyezon Pasyan ki ka evalye, kalkile epi bay pasyan yo depans aktyèl yo soti nan pòch yo. Ou ka kontakte ekip Lyezon Pasyan nou an nan Patientbilling@complete-care.com.
| Kòd CPT | Deskripsyon Kòd | Kantite lajan Fakti |
| X-Ray la | ||
| 70030 | X-Ray Je Kò Etranje | $92.37 |
| 70100 | Xray nan mandib la; 1-3 opinyon | $107.88 |
| 70110 | Xray nan mandib la; 4 opinyon | $121.98 |
| 70250 | Xray nan zo bwa tèt la; 1-3 vi | $106.62 |
| 70330 | Xray, jwenti temporomandibular, bouch ouvè ak fèmen; bilateral | $147.45 |
| 71045 | Xray, pwatrin | $73.23 |
| 71046 | Xray, pwatrin, gade sèl | $94.44 |
| 71048 | X-ray pwatrin, 4 oswa plis gade | $127.80 |
| 71100 | Xray, zo kòt, inilateral, 2 opinyon | $102.63 |
| 71101 | Xray, zo kòt, inilateral, 3 opinyon | $117.54 |
| 71110 | Xray, zo kòt, bilateral, 3 opinyon | $125.22 |
| 71111 | Xray, zo kòt, bilateral, 4 opinyon | $149.34 |
| 71120 | Xray, sternum, 2 opinyon | $101.01 |
| 72040 | Xray, nan kòl matris, 2 oswa 3 opinyon | $110.85 |
| 72050 | Xray, nan kòl matris, 4 opinyon | $150.36 |
| 72052 | Xray, nan kòl matris, 6+ opinyon | $182.91 |
| 72070 | Xray, thoracic, 2 opinyon | $103.29 |
| 72072 | Xray, thoracic, 3 opinyon | $114.27 |
| 72100 | Xray, lonbosakral, 2 oswa 3 opinyon | $110.85 |
| 72110 | Xray, lonbosakral, 4 opinyon | $151.41 |
| 72170 | Xray, basen, 1 oswa 2 opinyon | $80.91 |
| 72220 | Xray, sakrom ak koksis, 2 opinyon | $91.41 |
| 73000 | Xray, klavikul, konplè | $91.35 |
| 73010 | Xray, scapula, konplè | $83.04 |
| 73020 | Xray, zepòl, 1 vi | $72.24 |
| 73030 | Xray, zepòl, 2 opinyon | $96.93 |
| 73050 | Xray, jwenti akromioclavicular, bilateral, avèk oswa san distraksyon filaplon | $105.27 |
| 73060 | Xray, imè, 2 opinyon | $89.52 |
| 73070 | Xray, koud, 2 opinyon | $82.23 |
| 73080 | Xray, koud, 3 opinyon | $94.41 |
| 73090 | Xray, avanbra, 2 opinyon | $79.77 |
| 73100 | Xray, ponyèt, 2 opinyon | $94.08 |
| 73110 | Xray, ponyèt, 3 opinyon | $115.11 |
| 73120 | Xray, men, konplè, 3 opinyon | $87.69 |
| 73130 | Xray, men, 2 opinyon | $104.19 |
| 73140 | Xray, dwèt (yo), 2 opinyon | $106.68 |
| 73501 | Xray, anch, inilateral, ak basen lè yo fè, 1 gade | $93.30 |
| 73502 | Xray, anch, inilateral, ak basen lè fè, 2-3 opinyon | $132.75 |
| 73503 | Xray, anch, inilateral, ak basen lè yo fèt, minimòm 4 opinyon | $169.11 |
| 73521 | Xray, ranch, bilateral, ak basen lè fè, 2 opinyon | $115.41 |
| 73551 | Xray, femoral, 1 gade | $83.13 |
| 73552 | Xray, femoral, 2 opinyon | $99.66 |
| 73560 | Xray, jenou; 1 oswa 2 opinyon | $95.01 |
| 73562 | Xray, jenou, 3 opinyon | $113.37 |
| 73590 | Xray, tibya ak fibula, 2 opinyon | $88.62 |
| 73600 | Xray, cheviy, 2 opinyon | $89.52 |
| 73610 | Xray, cheviy, konplè, 3 opinyon | $101.43 |
| 73620 | Xray, pye, 2 opinyon | $79.50 |
| 73630 | Xray, pye, konplè, 3 opinyon | $95.04 |
| 73650 | Xray, calcaneus (zo talon pye), 2 opinyon | $79.50 |
| 73660 | Xray, zòtèy (yo), 2 opinyon | $81.15 |
| 76120 | Cineradiography/videyoradiography, eksepte kote espesyalman enkli | $303.84 |
| 76499 | Konsèy ultrasons pou plasman zegwi (egzanp, byopsi, aspirasyon, piki, aparèy lokalizasyon), sipèvizyon D ak entèpretasyon. | $500.00 |
| 76942 | Pwosedi radyografi dyagnostik ki pa nan lis la | $451.71 |
| MRI | ||
| 70551 | Mri sèvo san koloran | $1,500.00 |
| 71550 | Mri pwatrin san lank | $1,500.00 |
| 72141 | Mri kou kolòn vètebral san koloran | $1,500.00 |
| 72146 | Mri pwatrin kolòn vètebral san koloran (torasik) | $1,500.00 |
| 72148 | Mri lonbèr kolòn vètebral san koloran | $1,500.00 |
| 72195 | Mri basen san koloran | $1,500.00 |
| 73218 | Mri ekstremite siperyè san koloran | $1,500.00 |
| 73221 | Mri jwenti upr extrem w/o dye | $1,500.00 |
| 73718 | Mri ekstremite pi ba san koloran | $1,500.00 |
| 73721 | Mri jnt nan lwr extre w/o dye | $1,500.00 |
| 74181 | Mri vant san lank | $1,500.00 |
| 76376 | Neuro Quant | $400.00 |
| Nenpòt MRI CPT | Konparezon MRI | $450.00 |
| Orè Frè pou Swen Blesi ak Sèvis Reyabilitasyon | ||
| 96138 | Tès sikolojik oswa nerosikolojik | $95.37 |
| 97010 | Aplikasyon yon modalite nan 1 oswa plis zòn; pake cho oswa frèt | $19.11 |
| 97012 | Aplikasyon yon modalite nan 1 oswa plis zòn; traction, mekanik | $42.09 |
| 97014 | Aplikasyon yon modalite nan 1 oswa plis zòn; eksitasyon elektrik (san siveyans) | $39.84 |
| 97110 | Pwosedi terapetik, 1 oswa plis zòn, chak 15 minit; egzèsis terapetik pou devlope fòs ak andirans, ran de mouvman ak fleksibilite | $84.30 |
| 97112 | Pwosedi terapetik, 1 oswa plis zòn, chak 15 minit; reedikasyon neromiskilè mouvman, balans, kowòdinasyon, sans kinestezi, pwèstans, ak/oswa propriyosepsyon pou aktivite chita ak/oswa kanpe. | $93.72 |
| 97140 | Teknik terapi manyèl (egzanp, mobilizasyon/manipilasyon, drenaj lenfatik manyèl, traction manyèl), 1 oswa plis rejyon, chak 15 minit. | $79.65 |
| 97150 | Pwosedi terapetik (yo), gwoup (2 oswa plis moun) | $51.45 |
| 97161 | Evalyasyon Terapi Fizik - Konpleksite ki ba | $287.40 |
| 97164 | Re-evalyasyon terapi fizik etabli plan swen | $197.25 |
| 97530 | Aktivite terapetik, kontak dirèk (yon sèl-a-yon sèl) pasyan (itilize aktivite dinamik pou amelyore pèfòmans fonksyonèl), chak 15 minit. | $100.68 |
| 97535 | Fòmasyon pou swen pwòp tèt ou/jesyon lakay (egzanp, aktivite lavi chak jou (ADL) ak fòmasyon konpansatwa, preparasyon manje, pwosedi sekirite, ak enstriksyon pou itilize aparèy teknoloji asistans/ekipman adaptasyon) kontak dirèk youn a youn, chak 15 minit. | $93.45 |
| 97760 | Jesyon ak fòmasyon ortèz (ki gen ladan evalyasyon ak ajisteman lè yo pa rapòte otreman), ekstremite siperyè (yo), ekstremite pi ba (yo) ak/oswa kòf, premye rankont ortèz (yo), chak 15 minit. | $132.96 |
| 98975 | Siveyans terapetik adistans (egzanp, estati sistèm respiratwa, estati sistèm miskiloskelèt, aderans terapi, repons terapi); premye konfigirasyon ak edikasyon pasyan sou itilizasyon ekipman yo | $56.67 |
| 98977 | Siveyans terapetik adistans (egzanp, estati sistèm respiratwa, estati sistèm miskiloskelèt, aderans terapi, repons terapi); aparèy (yo) bay ak pwograme (pa egzanp, chak jou) anrejistreman (yo) ak/oswa pwograme alèt (yo) transmisyon pou kontwole sistèm miskiloskelèt, chak 30 jou | $121.83 |
| 98980 | Sèvis jesyon tretman siveyans terapetik adistans, tan doktè/lòt pwofesyonèl swen sante ki kalifye nan yon mwa kalandriye ki mande pou omwen yon kominikasyon entèaktif ak pasyan an/moun kap bay swen an pandan mwa kalandriye a; premye 20 minit | $147.03 |
| 98981 | Sèvis jesyon tretman siveyans terapetik adistans, tan doktè/lòt pwofesyonèl swen sante ki kalifye nan yon mwa kalandriye ki mande pou omwen yon kominikasyon entèaktif ak pasyan an/moun kap bay swen an pandan mwa kalandriye a; chak 20 minit adisyonèl (lis separeman anplis kòd pou pwosedi prensipal la) | $115.98 |
| G0283 | Eksitasyon elektrik (san siveyans), nan youn oswa plis zòn pou endikasyon (yo) ki pa swen blesi, kòm yon pati nan yon plan terapi swen. | $36.21 |
| Ajisteman | ||
| 98940 | Tretman kiwopratik manipilatif (CMT); epinyè, 1-2 rejyon yo | $78.00 |
| 98941 | Tretman kiwopratik manipilatif (CMT); epinyè, 3-4 rejyon yo | $113.19 |
| 98942 | Tretman kiwopratik manipilatif (CMT); epinyè, 5 rejyon yo | $146.58 |
| 98943 | Tretman kiwopratik manipilatif (CMT); extraspinal, 1 oswa plis rejyon | $32.00 |
| Konsilte | ||
| 99202 | Biwo Nouvo Pasyan ~ 15-29 Min | $206.01 |
| 99203 | Biwo Nouvo Pasyan ~ 30-44 Min | $324.90 |
| 99204 | Biwo Nouvo Pasyan ~ 45-59 Min | $813.45 |
| 99211 | Biwo Etabli Pasyan | $65.40 |
| 99212 | Biwo Etabli Pasyan ~ 10-19 Min | $161.70 |
| 99213 | Biwo Etabli Pasyan ~ 20-29 Min | $263.52 |
| 99214 | Biwo Etabli Pasyan ~ 30-39 Min (Re-Egzamen) | $619.75 |
| 99446 | Telemed (Telefòn/Entènèt) ~ 5-10 Min | $51.93 |
| 99448 | Telemed (Telefòn/Entènèt) ~ 21-30 Min | $155.25 |
| Sante Mantal | ||
| 90785 | Psytx konplèks entèaktif | $42.57 |
| 90791 | eva dyagnostik sikyatrik; san sèvis medikal | $498.15 |
| 90792 | eva dyagnostik sikyatrik; ak sèvis medikal | $562.38 |
| 90832 | Sikoterapi endividyèl, 30 minit | $235.44 |
| 90833 | Sikoterapi endividyèl, 30 minit ak sèvis eval ak jesyon (E/M) | $217.86 |
| 90834 | Sikoterapi endividyèl, 45 minit | $310.53 |
| 90836 | Sikoterapi endividyèl, 45 minit ak E/M | $277.08 |
| 90837 | Sikoterapi endividyèl, 60 minit | $460.32 |
| 90838 | Sikoterapi endividyèl, 60 minit ak E/M | $369.24 |
| 90839 | Sikoterapi pou kriz, premye 60 minit | $443.76 |
| 90840 | Sikoterapi pou kriz, chak 30 minit anplis | $217.86 |
| 90845 | Psikanaliz | $296.49 |
| 90846 | Sikoterapi Fanmi san kliyan prezan, 50 minit | $296.58 |
| 90847 | Sikoterapi Fanmi ak kliyan prezan, 50 minit | $318.48 |
| 90853 | Sikoterapi gwoup (lòt ke gwoup milti-fanmi) | $89.34 |
| Tès nero | ||
| 95924 | NCV | $417.45 |
| 95923 | NCV | $329.79 |
| 95913 | NCV | $804.78 |
| 95912 | NCV | $687.36 |
| 95911 | NCV | $588.45 |
| 95910 | NCV | $489.15 |
| 95909 | NCV | $373.92 |
| 95908 | NCV | $310.86 |
| 95907 | NCV | $250.11 |
| 95905 | NCV | $90.72 |
| 95886 | EMG | $261.96 |
| 95885 | EMG | $165.84 |
| 95875 | EMG | $337.35 |
| 95870 | EMG | $222.60 |
| 95864 | EMG | $621.87 |
| 95863 | EMG | $587.82 |
| 95861 | EMG | $433.98 |
| 95860 | EMG | $310.08 |
| 95851 | EMG | $68.04 |
| 92540 | VNG | $296.70 |
| 92541 | VNG | $158.37 |
| 92542 | VNG | $161.82 |
| 92544 | VNG | $129.39 |
| 92545 | VNG | $118.59 |
| 92547 | VNG | $28.29 |
| 92546 | VNG | $364.44 |
| 92548 | Balans | $295.98 |
| 92537 | kalorik (4) | $111.24 |
| 92538 | kalorik (4) | $62.97 |
| 20553 | TPI (3 oswa plis) | $173.55 |
| 20610 | Piki jwenti | $200.64 |
| Ekipman medikal dirab (DME) | ||
| A4467 | Manch jenou | $24.02 |
| A4565 | Fistibal | $31.53 |
| A9270 | Walker bòt | $133.73 |
| E0100 | Kann nan nenpòt materyèl | $88.35 |
| E0105 | 4 fil kann | $205.89 |
| E0114 | Beki | $174.57 |
| E0143 | Walker | $177.87 |
| E0720 | TENS - dernye aparèy depi 06/03/2024 | $518.31 |
| E0730 | DÈZ | $2,223.33 |
| E0855 | Ponp pozisyon | $2,965.29 |
| L0120 | Kòl mou nan matris | $198.57 |
| L0170 | Kolye nan matris (moule) | $4,978.47 |
| L0172 | Kolye imobilizasyon nan matris | $1,009.35 |
| L0180 | Kolye nan matris (plizyè pòs) | $2,466.09 |
| L0456 | T. Atèl dèyè | $7,059.45 |
| L0621 | Atèl ortèz sacroiliac | $433.89 |
| L0623 | Òtoz Sacroiliac (SO) | $777.81 |
| L0625 | LSO mou | $242.73 |
| L0627 | Orthosis lonbèr, kontwòl sagittal ak panno rijid anteryè ak dèyè | $2,917.77 |
| L0642 | Mwayen LSO (Te itilize pou L0627) | $1,811.25 |
| L0648 | LSO rijid (Te itilize pou L0631) | $4,523.43 |
| L0650 | LSO | $5,233.89 |
| L1810 | Lateral estabilizasyon jenou atèl | $859.29 |
| L1820 | Atèl jenou | $855.87 |
| L1832 | Shortrunner jenou atèl | $5,350.95 |
| L1833 | Atèl jenou gon teleskop | $3,155.43 |
| L1851 | Atèl jenou OA (Te itilize pou K0901) | $4,164.87 |
| L1902 | Atèl cheviy ak oswa san jwenti | $542.19 |
| L1971 | AFO | $3,326.97 |
| L2397 | Atèl jenou Cobra | $773.67 |
| L3670 | Òtoz zepòl | $925.29 |
| L3675 | Estabilize zepòl ak eleman vès | $1,133.61 |
| L3760 | Brace koud gon | $2,870.25 |
| L3807 | Atèl ponyèt ak gwo pous | $1,615.29 |
| L3906 | Ponyèt atèl san jwenti | $2,725.05 |
| L3908 | Atèl ponyèt | $386.97 |
| L3915 | Atèl ponyèt ak men | $3,433.89 |
| L3923 | Atèl | $561.87 |
| L4360 | Kam Frakti Mache Boot | $1,941.93 |
| L4387 | Bòt mache, ki pa pneumatik, avèk oswa san jwenti, avèk oswa san materyèl koòdone, prefabrike, sou etajè a | $1,125.27 |
| J3490 | Patch lidokayin | $354.75 |
| Orè frè pou kolòn vètebral ak sèvis òtopedik | ||
| 96138 | Tcheke nan sèvo | $63.58 |
| 62321 | ESI nan matris | $1,456.80 |
| 62323 | Lonbèr ESI | $1,430.34 |
| 64479 | ESI nan matris (transfòme) | $1,878.42 |
| 64483 | Lonbèr ESI (transfòme) | $1,880.16 |
| 20550 | Piki tandon | $338.22 |
| 20551 | Inj tandon orijin/Insert | $332.52 |
| 20553 | TPI (3 oswa plis) | $347.10 |
| 20552 | TPI (1-2 misk) | $301.26 |
| 20600 | Piki jwenti | $519.00 |
| 20605 | Piki jwenti W/O ultrason | $538.70 |
| 20606 | Piki jwenti ak ultrason | $862.50 |
| 20610 | Piki jwenti | $668.80 |
| 20611 | Drenaj/inj jwenti/bursa w/nou | $954.70 |
| 27096 | SI Joint piki | $1,891.80 |
| 10140 | Drenaj nan yon ematom | $1,614.10 |
| 0232T | Piki PRP nan biwo a | $4,637.58 |
| 64405 | 3yèm blòk nè oksipital | $982.00 |
| 64445 | nè blòk Njx aa&/strd nè syatik | $1,477.20 |
| 64450 | Blòk nè periferik | $937.10 |
| 64490 | C MBB/Facet 1 nivo | $1,815.70 |
| 64491 | C MBB/Facet 2 nivo | $935.60 |
| 64492 | C MBB/Facet 3 nivo & adisyonèl | $930.80 |
| 64493 | L MBB/Facet 1 nivo | $1,674.40 |
| 64494 | L MBB/Facet 2 nivo | $863.50 |
| 64495 | L MBB/Facet 3 nivo & adisyonèl | $851.00 |
| 64447 | Njx aa&/strd nè femoral | $1,106.30 |
| 64633 | C/T RFN 1 nivo | $4,034.90 |
| 64634 | C/T RFN 2 nivo & adisyonèl | $2,316.00 |
| 64635 | L/S RFN 1 nivo | $4,066.60 |
| 64636 | L/S RFN 2 nivo ak adisyonèl | $2,171.40 |
| 64625 | SI RFN (1 nivo sèlman) | $4,366.70 |
| 64999 | ki pa nan lis (pri ka varye) | |
| J7322 | Hymovis piki 1 | $4,560.48 |
| J7322 | Hymovis piki 2 | $9,120.96 |
| J0171 | Adrenalin | $14.80 |
| J1010 | 40 Depo | $66.90 |
| J1040 | 80 Depo | $129.60 |
| J2001 | Lidokane | $32.00 |
| J3490 | Patch Lidocane | $55.00 |
| S0020 | Bupivacaine | $7.30 |
| c9290 | Bupivicane lipozom | $166.25 |
| Q9966 | Omnupaque | $102.20 |
| J1100 | Dexamethasone | $20.88 |
| J3301 | Kenalog | $100.00 |
| 99441 | Kòd telefòn 5-10 min | $282.12 |
| 99442 | Kòd telefòn 11-20 min | $357.12 |
| 99443 | Kòd telefòn 21 -30 min | $507.04 |
| 99446 | Kòd telefòn (chanje kote sèvis) | $69.24 |
| 99447 | Kòd telefòn (chanje kote sèvis) | $139.68 |
| 99448 | Kòd telefòn (chanje kote sèvis) | $207.00 |
| 90785 | Psytx konplèks entèaktif | $28.37 |
| 90791 | Evalyasyon dyagnostik sikyatrik san sèvis medikal | $332.09 |
| 90792 | Evalyasyon dyagnostik sikyatrik ak sèvis medikal | $374.91 |
| 90832 | Sikoterapi endividyèl, 30 minit | $156.95 |
| 90833 | Sikoterapi endividyèl, 30 minit ak sèvis eval ak jesyon (E/M) | $145.23 |
| 90834 | Sikoterapi endividyèl, 45 minit | $207.01 |
| 90836 | Sikoterapi endividyèl, 45 minit ak E/M | $184.71 |
| 90837 | Sikoterapi endividyèl, 60 minit | $306.87 |
| 90838 | Sikoterapi endividyèl, 60 minit ak E/M | $246.15 |
| 90839 | Sikoterapi pou kriz, premye 60 minit | $295.83 |
| 90840 | Sikoterapi pou kriz, chak 30 minit anplis | $145.23 |
| 90845 | Psikanaliz | $197.65 |
| 90846 | Sikoterapi fanmi san kliyan prezan, 50 minit | $197.71 |
| 90847 | Sikoterapi fanmi ak kliyan prezan, 50 minit | $212.31 |
| 90853 | Sikoterapi gwoup (ki pa gwoup plizyè fanmi) | $59.55 |
| 95924 | NCV | $834.90 |
| 95923 | NCV | $659.58 |
| 95913 | NCV | $1,609.56 |
| 95912 | NCV | $1,374.72 |
| 95911 | NCV | $1,176.90 |
| 95910 | NCV | $978.30 |
| 95909 | NCV | $747.84 |
| 95908 | NCV | $621.72 |
| 95907 | NCV | $500.22 |
| 95905 | NCV | $181.44 |
| 95886 | EMG | $523.92 |
| 95885 | EMG | $331.68 |
| 95875 | EMG | $674.70 |
| 95870 | EMG | $445.20 |
| 95864 | EMG | $1,243.74 |
| 95863 | EMG | $1,175.64 |
| 95861 | EMG | $867.96 |
| 95860 | EMG | $620.16 |
| 95851 | EMG | $136.08 |
| 92540 | VNG | $593.40 |
| 92541 | VNG | $316.74 |
| 92542 | VNG | $323.64 |
| 92544 | VNG | $258.78 |
| 92545 | VNG | $237.18 |
| 92547 | VNG | $56.58 |
| 92546 | VNG | $728.88 |
| 92548 | Balans | $591.96 |
| 92537 | kalorik (4) | $222.48 |
| 92538 | kalorik (2) | $125.94 |
| 95816 | EEG reveye ak somnolans | $2,140.62 |
| 95819 | EEG reveye/dòmi | $2,490.12 |
| 95812 | EEG 41-60 min | $1,921.74 |
| 95813 | EEG pwolonje plis pase 60 minit | $2,453.76 |