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Claims Processing

last modified 03/12/2012 - 08:03 AM

Tools and information for claims processing

NOTE: Effective as of July 2009 dates of service and on-going, Medicaid rates paid to some providers will be reduced by 2%. The reduction will be captured in the last step of claims processing and is not reflected in the rates posted here. The remittance advice (RA) will state that the payment is a reduced amount of 2% from the posted DVHA fee schedules.

 

Fee Schedules: Definitions; CDT Codes; CPT Codes; Evaluation & Management (E & M); Durable Medical Equipment (DME); J Codes; HCPCS; Lab; Ladies First; PAC 8 & 9; Vision

2012 Fee Schedules

2011 Fee Schedules

2010 Fee Schedules

2009 Fee Schedules

 

OPPS Fee Schedules: Hospital Based Services for Out-Patient Billers

2012 OPPS Fee Schedules

2011 OPPS Fee Schedules

2010 OPPS Fee Schedules 

2009 OPPS Fee Schedules

 

Radiology / OPPS Radiology (MedSolutions/Prior Authorization)

2012 Radiology

2010 - 2011 Radiology

 

ICD9 Surgical Codes Requiring Prior Authorization

 

Dental Procedure/Fee Schedule 

  • January 1, 2011 (For services provided beginning 01/01/11) (Posted 05/23/11)
  • June 5, 2009 (For services provided beginning 6/5/09) (rev. 06/26/2009)(rev. 12/21/2010)
  • July 1, 2008 (For services provided from 7/1/08 through 6/4/09)
  • January 1, 2008 (For services provided from 1/1/08 through 6/30/08)

 

Transportation Fee Schedule

2011 Fee Schedule

 

Note: CPT and CDT codes, descriptions and other data only are copyright 2012 American Medical Association (AMA) and American Dental Association (ADA), respectively. All rights reserved. CPT is a registered trademark of the AMA. CDT is a registered trademark of the ADA. Applicable FARS and DFARS Restrictions apply to government use. The AMA and ADA assume no liability for data contained or not contained herein.