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1. Page 6, Paragraph 3, the words "Gifford area" were <br />changed to "Gifford/Wabasso/Oslo area". Words are to be <br />added to indicate that transportation concerns will be <br />addressed. <br />2. Schedule IV - the salary of the General Practice <br />Physician is to be raised from $40 to 45. <br />RECOMMENDATION: <br />The Committee joins Dr. Berman in asking that <br />1. The statement of Agreement be approved and signed by <br />the Chairman; <br />2. The fee schedule be approved. They are equal to <br />current Medicaid reimbursement; and <br />3. The Resolution of Endorsement for the Primary Care <br />Proposal be approved and signed by the Chairman. <br />The three requests are State HRS Primary Care Program <br />requirements. <br />INDIAN RIVER CMINTY PUBLIC HEALTH UNIT ATTACHMENT Q <br />CLINICAL FEE SCHEDULE <br />OFrIk VIaii ,.:,f„cLiSrED PATIENT) <br />Minimal <br />10.00 <br />Brief <br />SERVICES/PROCEDI <br />Limited <br />PROC----99N <br />SERVICES/PROCEDURES <br />CHARGE <br />PROC. CODE <br />----______Y_--- <br />24.00 <br />Comprehensive <br />36.00 <br />OFFICE VISIT (NEW PATIENT) <br />(CHN) <br />10.00 <br />INJECTIONS <br />PAP SMEAR <br />Hemoglobin (HGB) <br />Brief <br />30.00 <br />90000 <br />Oral Polio <br />No Chrg. <br />90712 <br />Limited <br />30.00 <br />90010 <br />DPT <br />No Chrg. <br />90701 <br />Intermediate <br />35.00 <br />90015 <br />MMR <br />No Chrg. <br />09707 <br />Extended <br />44.50 <br />90017 <br />TB Tine <br />5.00 <br />86585 <br />Comprehensive <br />50.00 <br />90020 <br />PPD. <br />5.00 <br />86580 <br />Pneumonococcal Vaccine <br />5.00 <br />01246 <br />OFFICE VISIT (ESTABLISHED PATIENT) <br />DT (Adult) <br />lU.N) <br />90702 <br />Minimal <br />12.00 <br />90030 <br />Brief <br />_1.50 <br />90040 <br />Fluogen (All Types) <br />5.00 <br />90702 <br />Limited <br />21.50 <br />")50 <br />HIB <br />5.00 <br />Intermediate <br />25.00 <br />90060 <br />Hepatitus A <br />10,00 <br />Extended <br />30.00 <br />90070 <br />Hepatitus B (Heptavax) <br />70.00 (cc) <br />Comprehensive <br />45.00 <br />90080 <br />Hepatitus B (Imm. Glob.) <br />70.00 (cc) <br />Rabies Vaccine <br />50.00 (Vial) <br />OFrIk VIaii ,.:,f„cLiSrED PATIENT) <br />Minimal <br />10.00 <br />Brief <br />17.00 <br />Limited <br />17.00 <br />Intermediate <br />20.00 <br />Extended <br />24.00 <br />Comprehensive <br />36.00 <br />EPSDT <br />School Physical <br />(MD) <br />20.00 <br />W9881 <br />School Physical <br />(CA) <br />16.00 <br />W9881 <br />School Physical <br />(NP) <br />16.00 <br />W9881 <br />School Physical <br />(CHN) <br />10.00 <br />W9981 <br />PAP SMEAR <br />Hemoglobin (HGB) <br />10.00 <br />88150 <br />MATERNITY <br />Ante Partum Care (Lon Risk) 800.00 <br />Ante Pattum Care (Hioh Risk) 1200.00 <br />New Pt. Comprehensive Vst. 50.00 <br />Established Pt. Limited Vst. 21.50 <br />OVERSEAS <br />Cholera 15.00 <br />Typhoid 10.00 <br />LABORATORY <br />COPIES <br />Blood Sugar Screening <br />5.00 <br />60.00 W9759 <br />Blood Sugar Fasting (SGOT) 5.00 <br />84450 <br />Culture/Skin <br />5.00 <br />87070 <br />Culture/Throat <br />5.00 <br />87060 <br />Hematocrit (HCT) <br />5.00 <br />85018 <br />Hemoglobin (HGB) <br />5.00 <br />85018 <br />Lead Blood <br />10.00 <br />Immunizations <br />O'Sullivan <br />10.00 <br />200.00 <br />Pregnancy Testing <br />5.00 <br />86006 <br />RH Factoring <br />12.00 <br />86105 <br />Sickle Cell <br />10.00 <br />85660 <br />Urine (Dip Stick) <br />3.00 <br />81000 <br />VDRL 1 <br />8.00 <br />86592 <br />PHARMACY CHARGE 12.00 <br />FAMILY PLANNING <br />COPIES <br />Initial/Post Partum Exam <br />60.00 W9759 <br />Medical Records (1-3 Pgs) <br />2.00 <br />Medical <br />39.00 <br />Medical Records (4-7 Pgs) <br />3.00 <br />Annual Exam <br />52.00 <br />Medical Legal Records <br />15.00 <br />Suoply/Counsel <br />14.00 <br />Physicals <br />1.00 <br />Tubal Lioation <br />625.00 <br />Immunizations <br />1.00 <br />Vasectomy <br />200.00 <br />MISCELLANEOUS <br />Speciality Referral <br />45.00 <br />Nutrition <br />20.00 <br />Health Education <br />20,00 <br />3 BOOK <br />NOV 31987 <br />7 F,a. E 0 <br />