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 |
|---|---|---|---|---|---|---|---|---|---|---|
| 93 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 134.16 | 0.00 | 0.00 | 07/01/2023 |
| 94 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 PM | 90791 | Psych diagnostic evaluation (not time dependent) | 150.15 | 129.35 | 150.15 | 07/01/2023 |
| 95 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 PM | 90832 | Psychotherapy, 30 minutes with patient and/or family member (minimum time = 15 min) | 64.94 | 57.03 | 64.94 | 07/01/2023 |
| 96 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 PM | 90832 | Psychotherapy, 30 minutes with patient and/or family member (minimum time = 15 min) | 56.06 | 0.00 | 0.00 | 07/01/2023 |
| 97 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 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 | 07/01/2023 |
| 98 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 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 | 07/01/2023 |
| 99 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 PM | 90834 | Psychotherapy 45 (38-52) min; Psychotherapy, 45 minutes with patient and/or family member | 130.80 | 0.00 | 0.00 | 07/01/2023 |
| 100 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 PM | 90834 | Psychotherapy 45 (38-52) min; Psychotherapy, 45 minutes with patient and/or family member | 85.81 | 75.56 | 85.81 | 07/01/2023 |
| 101 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 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 | 07/01/2023 |
| 102 | alex | 07/10/2024 03:28 PM | alex | 07/10/2024 03:28 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 | 07/01/2023 |
| CPT Code | Description | Allowable Amount** | Facility Rate** | Non-Facility Rate** | Effective Date |
*Provider type not specified. Some are default rates, community behavioral health
**$0.00 amounts indicate unavailable fee information.