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2008 HCPCS Updates
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New Rates for Drugs and DME
Information posted May 30, 2008: On May 19, 2008, the reimbursement rates for the following procedure codes were assigned at a public rate hearing: 1-90284, 9-A4252, 9-B4087, 9-B4088, 1-C9237, 1-C9238, 1-C9239, 1-C9240, 1-J0400, 1-J1571, 1-J1573, J/L-E2312, J/L-E2312-KC, J-E2313, 1-J2724, 1-J2778, 1-J7347, 1-J7349, 1-J9226, 1-J9303, and 9-K0672. Click on the title to view the details.

Effective for dates of service on or after January 1, 2008, the following reimbursement rates have changed:

Procedure Code

New Reimbursement Rate

1-90284

$10.20.

9-A4252

$3.56

9-B4087

$38.22

9-B4088

$38.22

1-C9237

$31.89

1-C9238

$0.46

1-C9239

$48.41

1-C9240

$651.52

1-J0400

$0.29

J-E2312

$1,939.18

J-E2312 with modifier KC

$2,473.18

L-E2312

$193.92

L-E2312 with modifier KC

$247.32

J-E2313

$307.93

1-J1571

$59.25

1-J1573

$59.25

1-J2724

$12.19

1-J2778

$405.89

1-J7347

$32.77

1-J7349

$40.86

1-J9226

$14,834.06

1-J9303

$82.88

9-K0672

$70.02

 

Effective for dates of service on or after April 1, 2008, procedure code 9-K0672 has a reimbursement rate of $70.02.

Affected claims will be reprocessed, and payments will be adjusted accordingly. No further action on the part of the provider is necessary.

For more information, call the TMHP Contact Center at 1-800-925-9126.

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