| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $339 | $339 | $339 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $168 | $168 | $168 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $172 | $172 | $172 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $224 | $224 | $224 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $218 | $218 | $218 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $303 | $303 | $303 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $262 | $262 | $262 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $317 | $317 | $317 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $167 | $167 | $167 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $246 | $246 | $246 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $255 | $255 | $255 |
| Group psychotherapy CPT 90853 • Mental Health | $60 | $62 | $63 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $11 | $11 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $153 | $280 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $320 | $320 | $320 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $318 | $318 | $318 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $139 | $139 | $139 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $857 | $857 | $857 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $281 | $281 | $281 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $203 | $203 | $203 |
| EMG needle each extremity complete CPT 95886 • Neurology | $228 | $228 | $228 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $95 | $95 | $95 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $163 | $163 | $163 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $342 | $342 | $342 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $190 | $190 | $190 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $260 | $260 | $260 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $160 | $163 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $227 | $241 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $348 | $365 | $381 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $441 | $473 | $505 |
| Office visit established patient minimal CPT 99211 • Office Visits | $48 | $50 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $55 | $92 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $158 | $182 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $230 | $261 | $292 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $239 | $326 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $218 | $223 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $295 | $301 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $434 | $442 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $84 | $86 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $155 | $159 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $224 | $228 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $156 | $160 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $229 | $234 | $238 |
| Consultation office straightforward CPT 99241 • Office Visits | $49 | $49 | $49 |
| Consultation office low complexity CPT 99243 • Office Visits | $217 | $240 | $263 |
| Consultation office high complexity CPT 99245 • Office Visits | $482 | $490 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,317 | $1,317 | $1,317 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $111 | $111 | $111 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,848 | $2,848 | $2,848 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $500 | $500 | $500 |