AMOUNT AMOUNT AMOUNT AMOUNT AMOUNT Effective PROCEDURE DESCRIPTION UNIT Effective 2/22/17 to Effective Effective CODE Effective 7/29/16 to 6/30/17 and 7/1/17 to 8/1/18 7/1/19 2/21/17 7/1/18 to 6/30/18 to 6/30/19 7/31/18 Personal Support 15 S5125 UN Services (FPSO) multiple N/A $2.04 $2.04 $2.05 $2.05 minutes patients (2) Personal Support 15 S5125 UP Services (FPSO) multiple N/A $1.49 $1.49 $1.49 $1.49 minutes patients (3) Skills Training (FPSO 15 $14.03 $14.03 H2014 $14.03 $14.03 $14.03 minutes only) Care Coordination 15 G9001 $17.00 $17.00 $17.00 $17.00 $17.00 Service (Initial Visit) minutes Care Coordination 15 G9002 Service (Maintenance $17.00 $17.00 $17.00 $17.00 $17.00 minutes Visit) 15 S5120 Services $2.30 $2.30 $2.30 $2.30 $2.30 minutes
PROCEDURE CODE DESCRIPTION UNIT AMOUNT Effective 7/29/16 to 2/21/17 AMOUNT Effective 2/22/17 to 6/30/17 and 7/1/18 to 7/31/18 AMOUNT Effective 7/1/17 to 6/30/18 AMOUNT Effective 8/1/18 to 6/30/19 AMOUNT Effective 7/1/19 S5125 UN Personal Support Services (FPSO) multiple patients (2) 15 minutes N/A $2.04 $2.04 $2.05 $2.05 S5125 UP Personal Support Services (FPSO) multiple patients (3) 15 minutes N/A $1.49 $1.49 $1.49 $1.49 H2014 Skills Training (FPSO only) 15 minutes $14.03 $14.03 $14.03 $14.03 $14.03 G9001 Care Coordination Service (Initial Visit) 15 minutes $17.00 $17.00 $17.00 $17.00 $17.00 G9002 Care Coordination Service (Maintenance Visit) 15 minutes $17.00 $17.00 $17.00 $17.00 $17.00 S5120 Services 15 minutes $2.30 $2.30 $2.30 $2.30 $2.30
c3s096.docx