| Psychotherapy 30 minutes CPT 90832 • Mental Health | $74 | $74 | $74 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $61 | $61 | $61 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $98 | $98 | $98 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $77 | $77 | $77 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $139 | $179 | $254 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $102 | $102 | $102 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $138 | $138 | $138 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $61 | $61 | $61 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $94 | $94 | $94 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $98 | $98 | $98 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $26 | $26 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $72 | $421 | $595 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $95 | $479 | $977 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $83 | $349 | $595 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $54 | $54 | $54 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $365 | $365 | $365 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $59 | $59 | $59 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $154 | $154 | $154 |
| EMG needle each extremity complete CPT 95886 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $35 | $35 | $35 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $107 | $107 | $107 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $53 | $53 | $53 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $101 | $101 | $101 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $179 | $179 | $179 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $90 | $105 | $113 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $140 | $163 | $174 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $208 | $240 | $278 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $275 | $319 | $367 |
| Office visit established patient minimal CPT 99211 • Office Visits | $29 | $33 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $45 | $73 | $87 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $113 | $132 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $123 | $166 | $214 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $224 | $263 | $282 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $104 | $139 | $157 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $164 | $195 | $211 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $219 | $293 | $331 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $60 | $61 | $62 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $100 | $108 | $112 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $150 | $157 | $161 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $102 | $108 | $112 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $144 | $162 | $175 |
| Consultation office low complexity CPT 99243 • Office Visits | $112 | $162 | $187 |
| Consultation office high complexity CPT 99245 • Office Visits | $266 | $286 | $296 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $714 | $960 | $1,171 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $35 | $742 | $977 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $977 | $1,450 | $2,500 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $351 | $768 | $977 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $977 | $1,162 | $1,450 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $977 | $1,079 | $1,450 |