Regulation .12 Evaluation and Management Services — Including Medication Management.
Regulation .12 Evaluation and Management Services — Including Medication Management.LinkCopy Citation
A.
New Patients. The Department shall reimburse for evaluation and management services for new patients, including medication management:
(1)
For a problem focused history, or a problem focused examination, and straightforward medical decision making of minor complexity:
(a)
OMHC ... $48.70;
(b)
Physician ... $48.70;
(c)
Certified registered nurse practitioner — psychiatric ... $48.70;
(2)
For an expanded problem focused history, or an expanded problem focused examination, and straightforward medical decision making:
(a)
OMHC ... $82.48;
(b)
Physician ... $82.48;
(c)
Certified registered nurse practitioner — psychiatric ... $82.48;
(3)
For a detailed history, or a detailed examination, and medical decision of low complexity:
(a)
OMHC ... $119.25;
(b)
Physician ... $119.25;
(c)
Certified registered nurse practitioner — psychiatric ... $119.25;
(4)
For a comprehensive history, or a comprehensive medical examination, with medical decision making of moderate complexity:
(a)
OMHC ... $181.64;
(b)
Physician ... $181.64;
(c)
Certified registered nurse practitioner — psychiatric ... $181.64;
(5)
For a comprehensive history, or a comprehensive medical examination, with medical decision making of high complexity:
(a)
OMHC ... $224.53;
(b)
Physician ... $224.53;
(c)
Certified registered nurse practitioner — psychiatric ... $224.53.
B.
Established Patients. The Department shall reimburse for evaluation and management services for established patients, including medication management:
(1)
For a history, or examination, where presenting problems are minimal, and straightforward medical decision making of minor complexity:
(a)
OMHC ... $22.72;
(b)
Physician ... $22.72;
(c)
Certified registered nurse practitioner — psychiatric ... $22.72;
(2)
For a problem focused history, or a problem focused examination, and straightforward medical decision making:
(a)
OMHC ... $48.70;
(b)
Physician ... $48.70;
(c)
Certified registered nurse practitioner — psychiatric ... $48.70;
(3)
For an expanded history, or an expanded examination, and medical decision of low complexity:
(a)
OMHC ... $80.11;
(b)
Physician ... $80.11;
(c)
Certified registered nurse practitioner — psychiatric ... $80.11;
(4)
For a detailed history, or a detailed medical examination, with medical decision making of moderate complexity:
(a)
OMHC ... $117.60;
(b)
Physician ... $117.60;
(c)
Certified registered nurse practitioner — psychiatric ... $117.60;
(5)
For a comprehensive history, or a comprehensive medical examination, with medical decision making of high complexity:
(a)
OMHC ... $157.64;
(b)
Physician ... $157.64;
(c)
Certified registered nurse practitioner — psychiatric ... $157.64.