92526 N 1 $80.85 Treatment of swallowing dysfunction and/or oral function for feeding 92610 N 1 $81.43 Evaluation of oral and pharyngeal swallowing function 92626 N 1 $70.21 Evaluation of auditory rehabilitation status 92627 Evaluation of auditory N 3 $17.37 rehabilitation EPSDT Nutrition Services Procedure Description Requires Maximum Maximum Code Pre-Auth Payment Number of Units 97802 Nutrition Assessment N 4 $30.03 and intervention 97803 Nutrition N 4 $26.35 assessment and intervention 97804 Group Nutrition N 1 $13.55 Service PLEASE NOTE: Services are reimbursed up to the maximum units as indicated on this schedule. Providers enrolled as a Therapy Group (Provider Type 28) may bill the per visit charge for each discipline participating in the group. Please refer to the fee schedule for enrolled maximum reimbursement. Claims must reflect the above referenced procedure codes for proper reimbursement. These codes are specific to services outlined in the Provider Manual for EPSDT acupuncture, nutrition, chiropractic, speech language pathology, and occupational therapies, as well as physical therapy services, and they are specific to the Maryland Medical Assistance Fee-for-Service system of payment.
92526 Treatment of swallowing dysfunction and/or oral function for feeding N 1 $80.85 92610 Evaluation of oral and pharyngeal swallowing function N 1 $81.43 92626 Evaluation of auditory rehabilitation status N 1 $70.21 92627 Evaluation of auditory rehabilitation N 3 $17.37 EPSDT Nutrition Services Procedure Code Description Requires Pre-Auth Maximum Number of Units Maximum Payment 97802 Nutrition Assessment and intervention N 4 $30.03 97803 Nutrition and intervention N 4 $26.35 97804 Group Nutrition Service N 1 $13.55 PLEASE NOTE: Services are reimbursed up to the maximum units as indicated on this schedule. Providers enrolled as a Therapy Group (Provider Type 28) may bill the per visit charge for each enrolled discipline participating in the group. Please refer to the fee schedule for maximum reimbursement. Claims must reflect the above referenced procedure codes for proper reimbursement. These codes are specific to services outlined in the Provider Manual for EPSDT acupuncture, nutrition, chiropractic, speech language pathology, and occupational therapies, as well as physical therapy services, and they are specific to the Maryland Medical Assistance Fee-for-Service system of payment. assessment
EPSD-NEW-MANUAL-FINAL-01-01-18.docx