Evaluation & Management No – 843 Physical Health Other CD – □ Counseling 840-843 Physical Exam New/Existing Patient Select CPT Code from Range: – – New: Existing: 99382 99385 99392 99395 Select □ □ □ □ 99383 99386 99393 99396 Diagnosis: □ □ □ □ 99384 99387 99394 99397 □ □ □ □ Physical Exam – 840 Physical Exam Opioid Dependence – □ New/Established Patient Physical Exam – 841 Physical Exam Cocaine Dependence – □ New/Established Patient Physical Exam – 842 Physical Exam Alcohol Dependence – □ New/Established Patient Physical Exam – 843 Physical Exam Other CD – □ New/Established Patient Section Three Below is a list of OASAS certified programs that deliver the authorized SPA services; the applicable authorizing New York State program regulation; and where appropriate, a crosswalk to ASAM levels of care. OASAS Program Type New York State Regulation ASAM Outpatient Outpatient Clinic Title 14 NYCRR Part 822 Level I Outpatient Day Rehabilitation Title 14 NYCRR Part 822 Level II.5 Intensive Outpatient Title 14 NYCRR Part 822 Level II.I Opioid Treatment Programs Title 14 NYCRR Part 822 Level I
843 Physical Health – Other CD □ Evaluation & Management – No Counseling 840-843 Physical Exam – New/Existing Patient – Select CPT Code from Range: New: Existing: Select Diagnosis: □ 99382 □ 99385 □ 99392 □ 99395 □ 99383 □ 99386 □ 99393 □ 99396 □ 99384 □ 99387 □ 99394 □ 99397 840 Physical Exam – Opioid Dependence □ Physical Exam – New/Established Patient 841 Physical Exam – Cocaine Dependence □ Physical Exam – New/Established Patient 842 Physical Exam – Alcohol Dependence □ Physical Exam – New/Established Patient 843 Physical Exam – Other CD □ Physical Exam – New/Established Patient Section Three Below is a list of OASAS certified programs that deliver the authorized SPA services; the applicable authorizing New York State program regulation; and where appropriate, a crosswalk to ASAM levels of care. OASAS Program Type New York State Regulation ASAM Outpatient Outpatient Clinic Title 14 NYCRR Part 822 Level I Outpatient Day Rehabilitation Title 14 NYCRR Part 822 Level II.5 Intensive Outpatient Title 14 NYCRR Part 822 Level II.I Opioid Treatment Programs Title 14 NYCRR Part 822 Level I
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