| Postpartum care only CPT 59430 • Maternity | $217 | $217 | $217 |
| Cesarean delivery only CPT 59514 • Maternity | $758 | $758 | $758 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $1,655 | $1,655 | $1,655 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $98 | $98 | $98 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $112 | $112 | $112 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $77 | $77 | $78 |
| Interactive complexity add-on CPT 90785 • Mental Health | $12 | $13 | $13 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $111 | $133 | $147 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $181 | $183 | $187 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $54 | $62 | $70 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $61 | $63 | $64 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $71 | $85 | $100 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $62 | $67 | $71 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $97 | $101 | $105 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $109 | $111 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $114 | $123 | $131 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $44 | $55 | $67 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $76 | $94 | $112 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $93 | $96 | $99 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $32 | $40 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $103 | $103 | $103 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $111 | $111 | $111 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $107 | $107 | $107 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $353 | $353 | $353 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $409 | $409 | $409 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $102 | $104 | $106 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $143 | $143 | $143 |
| EMG needle each extremity complete CPT 95886 • Neurology | $92 | $92 | $92 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $85 | $85 | $85 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $103 | $104 | $106 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $167 | $167 | $167 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $275 | $275 | $275 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $65 | $69 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $91 | $93 | $94 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $116 | $126 | $135 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $140 | $180 | $210 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $21 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $46 | $47 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $76 | $81 | $86 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $17 | $52 | $122 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $145 | $149 | $152 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $67 | $69 | $71 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $118 | $124 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $140 | $147 | $151 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $45 | $47 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $66 | $68 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $108 | $113 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $69 | $73 | $77 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $102 | $109 |
| Consultation office low complexity CPT 99243 • Office Visits | $54 | $81 | $108 |