Vermont

Vermont*

wdt_ID wdt_created_by wdt_created_at wdt_last_edited_by wdt_last_edited_at CPT Code Description Allowed Amount** Fac Allowed**
1 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 134.16 0.00
2 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 150.15 129.35
3 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 150.15 129.35
4 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 150.15 129.35
5 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 150.15 129.35
6 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 150.15 129.35
7 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 150.15 129.35
8 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 150.15 129.35
9 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 0.00 0.00
10 alex 17/06/2024 01:05 PM alex 17/06/2024 01:05 PM 90791 Psych diagnostic evaluation (not time dependent) 0.00 0.00
CPT Code Description Allowed Amount** Fac Allowed**

*Provider type not specified. Some are default rates, community behavioral health
**$0.00 amounts indicate unavailable fee information.

Vermont Fee Schedule Definitions