Vermont
Vermont*
| wdt_ID | wdt_created_by | wdt_created_at | wdt_last_edited_by | wdt_last_edited_at | CPT Code | Description | Allowable Amount | Facility Rate | Non-Facility Rate | Effective Date | Additional Information |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 177 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 134.16 | 0.00 | 0.00 | 01/23/2007 | 37 (Provider type) |
| 178 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 150.15 | 129.35 | 150.15 | 01/23/2007 | Default rate |
| 179 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90832 | Psychotherapy, 30 minutes with patient and/or family member (minimum time = 15 min) | 64.94 | 57.03 | 64.94 | 01/23/2007 | 19 (Provider type) |
| 180 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90832 | Psychotherapy, 30 minutes with patient and/or family member (minimum time = 15 min) | 56.06 | 0.00 | 0.00 | 01/23/2007 | 37 (Provider type) |
| 181 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90833 | Add-on Psychotherapy 30 min (16-37); Psychotherapy, 30 minutes with patient and/or family when performed with an evaluation and management service | 47.17 | 0.00 | 0.00 | 01/23/2007 | 37 (Provider type) |
| 182 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90833 | Add-on Psychotherapy 30 min (16-37); Psychotherapy, 30 minutes with patient and/or family when performed with an evaluation and management service | 59.38 | 52.94 | 59.38 | 01/23/2007 | Default rate |
| 183 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90834 | Psychotherapy 45 (38-52) min; Psychotherapy, 45 minutes with patient and/or family member | 130.80 | 0.00 | 0.00 | 01/23/2007 | 37 (Provider type) |
| 184 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90834 | Psychotherapy 45 (38-52) min; Psychotherapy, 45 minutes with patient and/or family member | 85.81 | 75.56 | 85.81 | 01/23/2007 | Default rate |
| 185 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90836 | Add-on Psychotherapy 45 min (38-52); Psychotherapy, 45 minutes with patient and/or family when performed with an evaluation and management service | 120.08 | 0.00 | 0.00 | 01/23/2007 | 37 (Provider type) |
| 186 | alex | 09/20/2024 03:19 PM | alex | 09/20/2024 03:19 PM | 90836 | Add-on Psychotherapy 45 min (38-52); Psychotherapy, 45 minutes with patient and/or family when performed with an evaluation and management service | 75.26 | 67.06 | 75.26 | 01/23/2007 | Default rate |
| CPT Code | Description | Allowable Amount | Facility Rate | Non-Facility Rate | Effective Date | Additional Information |
*Provider type not specified. Some are default rates, community behavioral health
**$0.00 amounts indicate unavailable fee information.