Exhibit #8 Clinical Laboratory Fees Effective for Dates of Service on and after 1/1/2018 Maximum HCPCS Modifier SHORTDESC Fees 80171 30.91 Drug screen quant gabapentin 80173 33.97 Assay of haloperidol 80175 30.91 Drug screen quan lamotrigine 80176 34.26 Assay of lidocaine 80177 30.91 Drug scrn quan levetiracetam 15.42 Assay of lithium 80178 QW 15.42 Assay of lithium 80180 42.09 Drug scrn quan mycophenolate 80183 30.91 Drug scrn quant oxcarbazepin 80184 26.71 Assay of phenobarbital 80185 30.91 Assay of phenytoin total 80186 32.10 of phenytoin free 80188 38.69 of primidone 80190 39.07 Assay of procainamide 80192 39.07 Assay of procainamide 80194 34.05 Assay of quinidine 80195 32.03 Assay of sirolimus 80197 32.03 Assay of tacrolimus 80198 32.98 of theophylline 80199 42.11 Drug screen quant tiagabine 80200 37.60 Assay of tobramycin 80201 27.80 Assay of topiramate 80202 31.59 Assay of vancomycin 80203 30.91 Drug screen quant zonisamide 31.94 Quantitative assay drug 80305 25.43 Drug test prsmv dir opt obs 80306 33.92 Drug test prsmv instrmnt 80307 135.68 Drug test prsmv chem anlyzr 80400 76.06 Acth stimulation 80402 202.78 Acth stimulation panel 80406 145.67 Acth stimulation panel 80408 292.66 Aldosterone suppression eval 80410 187.36 Calcitonin stimul panel 80412 768.67 CRH stimulation panel 80414 120.41 Testosterone response 80415 130.32 Estradiol response panel 80416 307.73 Renin stimulation panel 80417 102.58 Renin stimulation panel
Exhibit #8 Clinical Laboratory Fees Effective for Dates of Service on and after 1/1/2018 HCPCS Modifier Maximum Fees SHORTDESC 80171 30.91 Drug screen quant gabapentin 80173 33.97 Assay of haloperidol 80175 30.91 Drug screen quan lamotrigine 80176 34.26 Assay of lidocaine 80177 30.91 Drug scrn quan levetiracetam 15.42 Assay of lithium 80178 QW 15.42 Assay of lithium 80180 42.09 Drug scrn quan mycophenolate 80183 30.91 Drug scrn quant oxcarbazepin 80184 26.71 Assay of phenobarbital 80185 30.91 Assay of phenytoin total 80186 32.10 of phenytoin free 80188 38.69 of primidone 80190 39.07 Assay of procainamide 80192 39.07 Assay of procainamide 80194 34.05 Assay of quinidine 80195 32.03 Assay of sirolimus 80197 32.03 Assay of tacrolimus 80198 32.98 of theophylline 80199 42.11 Drug screen quant tiagabine 80200 37.60 Assay of tobramycin 80201 27.80 Assay of topiramate 80202 31.59 Assay of vancomycin 80203 30.91 Drug screen quant zonisamide 31.94 Quantitative assay drug 80305 25.43 Drug test prsmv dir opt obs 80306 33.92 Drug test prsmv instrmnt 80307 135.68 Drug test prsmv chem anlyzr 80400 76.06 Acth stimulation 80402 202.78 Acth stimulation panel 80406 145.67 Acth stimulation panel 80408 292.66 Aldosterone suppression eval 80410 187.36 Calcitonin stimul panel 80412 768.67 CRH stimulation panel 80414 120.41 Testosterone response 80415 130.32 Estradiol response panel 80416 307.73 Renin stimulation panel 80417 102.58 Renin stimulation panel
Rule_18_2018_Exhibit_8_2018.docx