20 Miss. Code R. § 2-XII

Current through June 25, 2024
Section 20-2-XII - EXPERIMENTAL OR INVESTIGATIONAL PROCEDURES

See the General Rules section for information about procedures that are considered investigational or experimental for purposes of this Fee Schedule and are not approved for reimbursement.

Code

Description

Amount

PC Amount

TC Amount

FUD

Assist Surg

92507

TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND

131.57

XXX

N

92508

TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV

39.53

XXX

N

92521

EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)

189.39

XXX

N

92522

EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE

153.40

XXX

N

92523

EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION

326.86

XXX

N

95831

MUSC TSTG MNL W/REPRT XTR EX HAND/TRNK

54.28

XXX

N

95832

MUSC TSTG MNL W/REPRT HAND W/WO CMPRSN NRML SIDE

53.69

XXX

N

95833

MUSC TSTG MNL W/REPRT TOTAL EVAL BODY EX HANDS

70.80

XXX

N

95834

MUSC TSTG MNL W/REPRT TOTAL EVAL BODY W/HANDS

92.63

XXX

N

95836

ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS

185.26

XXX

N

95851

ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI

34.81

XXX

N

95852

ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID

31.27

XXX

N

97010

APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS

9.72

XXX

N

97012

APPL MODALITY 1/> AREAS TRACTION MECHANICAL

22.68

XXX

N

97014

APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED

22.68

XXX

N

97016

APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES

19.44

XXX

N

97018

APPL MODALITY 1/> AREAS PARAFFIN BATH

10.80

XXX

N

97022

APPLICATION MODALITY 1/> AREAS WHIRLPOOL

27.54

XXX

N

97024

APPLICATION MODALITY 1/> AREAS DIATHERMY

10.80

XXX

N

97026

APPLICATION MODALITY 1/> AREAS INFRARED

9.72

XXX

N

97028

APPL MODALITY 1/> AREAS ULTRAVIOLET

12.42

XXX

N

97032

APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN

22.68

XXX

N

97033

APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN

31.86

XXX

N

97034

APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN

23.22

XXX

N

97035

APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN

21.06

XXX

N

97036

APPL MODALITY 1/> AREAS HUBBARD TANK EA 15 MIN

53.46

XXX

N

97039

UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND

BR

XXX

N

97110

THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES

46.98

XXX

N

97112

THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA

53.46

XXX

N

97113

THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS

59.40

XXX

N

97116

THER PX 1/> AREAS EA 15 MIN GAIT TRAINJ W/STAIR

46.44

XXX

N

97124

THER PX 1/> AREAS EACH 15 MINUTES MASSAGE

43.74

XXX

N

97127

THERAPEUTIC IVNTJ W/FOCUS ON COGNITIVE FUNCTION

42.66

XXX

N

97139

UNLISTED THERAPEUTIC PROCEDURE SPECIFY

27.18

XXX

N

97140

MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES

42.66

XXX

N

97150

THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS

28.08

XXX

N

97151

BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN

BR

XXX

N

97152

BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN

BR

XXX

N

97153

ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN

BR

XXX

N

97154

GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN

BR

XXX

N

97155

ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN

BR

XXX

N

97156

FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN

BR

XXX

N

97157

MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN

BR

XXX

N

97158

GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN

BR

XXX

N

97161

PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS

129.60

XXX

N

97162

PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS

129.60

XXX

N

97163

PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS

129.60

XXX

N

97164

PHYSICAL THERAPY RE-EVAL EST PLAN CARE 20 MINS

88.02

XXX

N

97165

OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS

139.32

XXX

N

97166

OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS

139.32

XXX

N

97167

OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS

139.32

XXX

N

97168

OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS

95.58

XXX

N

97169

ATHLETIC TRAINING EVAL LOW COMPLEX 15 MINS

85.32

XXX

N

97170

ATHLETIC TRAINING EVAL MOD COMPLEX 30 MINS

99.36

XXX

N

97171

ATHLETIC TRAINING EVAL HIGH COMPLEX 45 MINS

113.94

XXX

N

97172

ATHLETIC TRAINING RE-EVAL EST PLAN CARE 20 MINS

71.28

XXX

N

97530

THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN

61.02

XXX

N

97533

SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES

65.34

XXX

N

97535

SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES

52.38

XXX

N

97537

COMMUNITY/WORK REINTEGRATION TRAINJ EA 15 MIN

50.22

XXX

N

97542

WHEELCHAIR MGMT EA 15 MIN

50.76

XXX

N

97545

WORK HARDENING/CONDITIONING 1ST 2 HR

130.68

XXX

N

+

97546

WORK HARDENING/CONDITIONING EACH HOUR

64.80

ZZZ

N

97597

DEBRIDEMENT OPEN WOUND 20 SQ CM/<

136.08

000

N

+

97598

DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM

42.66

ZZZ

N

97602

RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS

49.14

XXX

N

97750

PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN

53.46

XXX

N

97755

ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN

58.32

XXX

N

97760

ORTHOTICS MGMT & TRAINJ INITIAL ENCTR EA 15 MINS

72.90

XXX

N

97761

PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS

62.64

XXX

N

97763

ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN

77.22

XXX

N

97799

UNLISTED PHYSICAL MEDICINE/REHAB SERVICE/PROC

BR

XXX

N

97810

ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN

55.62

XXX

N

+

97811

ACUPUNCTURE 1/> NDLS W/O ELEC STIMJ EA 15 MIN

42.12

ZZZ

N

97813

ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN

61.02

XXX

N

+

97814

ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ

49.14

ZZZ

N

98925

OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS

52.51

000

N

98926

OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS

75.52

000

N

98927

OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS

99.12

000

N

98928

OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS

120.36

000

N

98929

OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS

143.96

000

N

98940

CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS

47.20

000

N

98941

CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS

68.44

000

N

98942

CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS

88.50

000

N

98943

CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION

45.43

XXX

N

99070

SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP

BR

XXX

N

20 Miss. Code. R. § 2-XII

Amended 6/14/2017
Amended 6/15/2019.