New Jersey
New Jersey*
| wdt_ID | wdt_created_by | wdt_created_at | wdt_last_edited_by | wdt_last_edited_at | CPT Code | Description | Specialist Allowable Amount | Non-Specialist Allowable Amount | Effective Date | Additional Information |
|---|---|---|---|---|---|---|---|---|---|---|
| 183 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 195.66 | 166.31 | 2024-01-01 | Base rate |
| 184 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 115.83 | 2024-01-01 | Modifier: AJ |
| 185 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 87.13 | 2024-01-01 | Modifier: AJ, 52 |
| 186 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 26.00 | 2024-01-01 | Modifier: HA |
| 187 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 191.05 | 2024-01-01 | Modifier: HF |
| 188 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 49.00 | 2024-01-01 | Modifier: HG |
| 189 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 0.00 | 2024-01-01 | Modifier: HH |
| 190 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 335.00 | 2024-01-01 | Modifier: HU |
| 191 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 166.94 | 2024-01-01 | Modifier: SA |
| 192 | alex | 09/20/2024 01:34 PM | alex | 09/20/2024 01:34 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 0.00 | 180.75 | 2024-01-01 | Modifier: SA, UC |
| CPT Code | Description | Specialist Allowable Amount | Non-Specialist Allowable Amount | Effective Date | Additional Information |
*Physician type not specified
**$0.00 amounts indicate unavailable fee information.