Procedure and Fee Schedules Effective July 1, 2018 EPSDT Acupuncture Services Code 97810 N 1 $28.37 1 or of more needles; P without electrical N 1 $21.11 initial without electrical minutes of personal each one-on- 97813 N 1 $30.27 with contact minutes electrical with the of patient personal initial 97814 N 1 $23.86 one-on- with minutes electrical contact of with the personal initial patient, with one minutes EPSDT Chiropractic Services contact of of with the personal needle(s) patient Description Procedure Requires Maximum Maximum Code Pre-Auth Payment one Number of Units contact with the 98940 Chiropractic Manipulative N 1 $22.00 patient, Treatment Spinal, 1 to 2 with regions 98941 N 1 $31.51 Chiropractic Manipulative of Treatment Spinal, 3 to 4 needle(s) regions 98942 N 1 $41.04 Chiropractic Manipulative Treatment Spinal, 5 regions 98943 N 1 $21.18 Chiropractic Manipulative Treatment Extra spinal, 1 or more regions
Procedure and Fee Schedules Effective July 1, 2018 EPSDT Acupuncture Services Code of 97810 1 or more needles; without electrical initial of personal contact with the patient N 1 $28.37 without electrical each of personal contact with the patient, with of needle(s) N 1 $21.11 97813 with electrical initial of personal one-on- one contact with the patient N 1 $30.27 97814 with electrical initial of personal one-on- one contact with the patient, with of needle(s) N 1 $23.86 EPSDT Chiropractic Services Procedure Code Description Requires Pre-Auth Maximum Number of Units Maximum Payment 98940 Chiropractic Manipulative Treatment Spinal, 1 to 2 regions N 1 $22.00 98941 Chiropractic Manipulative Treatment Spinal, 3 to 4 regions N 1 $31.51 98942 Chiropractic Manipulative Treatment Spinal, 5 regions N 1 $41.04 98943 Chiropractic Manipulative Treatment Extra spinal, 1 or more regions N 1 $21.18 minutes minutes minutes minutes P