Read 2007 Texas Medicaid Fee Schedule PRCR407c.xls text version

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS

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Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published

Texas Medicaid Fee Schedule Information Texas Health Steps (THSteps) and Intermediate Care Facility for the Mentally Retarded (ICF-MR) Dental Providers 2007

Dear Provider: The Texas Medicaid & Healthcare Partnership (TMHP) has compiled the Texas Medicaid fee schedules to help providers determine payment amounts for specific services. The schedules contain a list of procedure codes and corresponding reimbursement by the Texas Medicaid Program. This schedule is applicable to Texas Health Steps (THSteps) and Intermediate Care Facility for the Mentally Retarded (ICF-MR) dental providers only. Procedures listed in this fee schedule are payable based on the policies in effect for specific dates of service. Refer to the Texas Medicaid Provider Procedures Manual (TMPPM) and Texas Medicaid bulletins for program benefits, limitations, and approval processes. The reimbursement methodology for ICF-MR dental services is covered under 1 TAC §355.8081 and as access-based fees (ABFs) under 1 TAC §355.8085 . The reimbursement methodology for THSteps dental services is covered under 1 %TAC §355.8441(11). The following paragraphs are an overview of the current Texas Medicaid reimbursement methodologies used in this report. The reimbursement methodology for providers as defined in 1 TAC §355.8081 states that the reimbursement amount must not exceed the lesser of the provider's billed amount or the amount derived from the methodology described in §355.8085. The reimbursement methodology defined in 1 TAC §355.8085 includes resource-based fees (RBFs) and ABFs. RBFs are based on relative value units (RVUs) times the current Texas statewide conversion factor of $27.276. ABFs are developed to account for deficiencies in RBFs relating to adequate accessing of health care services for Medicaid clients. The fee schedule field descriptions below are a guide for using the fee schedule. TMHP hopes this information is helpful in determining payment amounts for services provided. Thanks to providers for participating in the Texas Medicaid Program.

Field Descriptions TOS: Type of service. One-character TOS and corresponding description. Proc code: Procedure code. Mod 1: 1st Modifier, if required for pricing determination. Mod 2: 2nd Modifier, if required for pricing determination. Client Age From: From age, if required for pricing determination. This is not the age restriction of the procedure. See the TMPPM for exact age limitations. Client Age Through: Through age, if required for pricing determination. This is not the age restriction of the procedure. See the TMPPM for exact age limitations. TMRM Payable: Texas Medicaid reimbursement methodology per 1 TAC §355.8085. The payable amount for the TOS and procedure code for providers, specifically RBFs. The payable amount is calculated by multiplying the total RVUs by the conversion factor ($27.276). Total RVUs: The current RVUs in TMHP files for the procedure code. Conv Factor: The conversion factor amounts for determining either the TMRM payable or the anesthesia payable amount. PPS Fee: Prospective Payment System (PPS) fee. Access-Based or Max Fee: The ABF amount or maximum fee. Note Code: Note code indicator. Providers should review each note code to identify specific payment explanation or limitation.

Note code description: 5 This procedure is manually reviewed to determine pricing.

Texas Medicaid & Healthcare Partnership, 12365-A Riata Trace Parkway, Austin, TX 78727

Note: Medicaid payments for services by professional and outpatient facilities under fee-for-service and Primary Care Case Management (PCCM) programs covered by this fee schedule are reduced by 2.5 percent effective September 1, 2003, with the exception of payments for drugs/biologicals, and durable medical equipment (DME)/supplies. For more information, refer to "Professional Providers and Outpatient Facilities Reimbursement Reduction" on page 2-6 of the 2007 TMPPM, which can be downloaded from the TMHP website at www.tmhp.com.

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS

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Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published AccessClient Based or Age Client Age TMRM Total Conv Proc Max Fee From Through Payable RVUs Factor PPS Fee TOS TOS Desc Code Mod 1 Mod 2 W THSteps D0120 0 999 $0.00 0 0 $0.00 $14.72 Dental/Orthodontia W THSteps D0140 0 999 $0.00 0 0 $0.00 $19.16 Dental/Orthodontia W THSteps D0150 0 999 $0.00 0 0 $0.00 $18.02 Dental/Orthodontia W THSteps D0160 0 999 $0.00 0 0 $0.00 $15.25 Dental/Orthodontia W THSteps D0170 0 999 $0.00 0 0 $0.00 $16.88 Dental/Orthodontia W THSteps D0180 0 999 $0.00 0 0 $0.00 $8.02 Dental/Orthodontia W THSteps D0210 0 999 $0.00 0 0 $0.00 $36.04 Dental/Orthodontia W THSteps D0220 0 999 $0.00 0 0 $0.00 $6.41 Dental/Orthodontia W THSteps D0230 0 999 $0.00 0 0 $0.00 $5.87 Dental/Orthodontia W THSteps D0240 0 999 $0.00 0 0 $0.00 $10.00 Dental/Orthodontia W THSteps D0250 0 999 $0.00 0 0 $0.00 $18.75 Dental/Orthodontia W THSteps D0260 0 999 $0.00 0 0 $0.00 $12.50 Dental/Orthodontia W THSteps D0270 0 999 $0.00 0 0 $0.00 $5.00 Dental/Orthodontia W THSteps D0272 0 999 $0.00 0 0 $0.00 $11.93 Dental/Orthodontia W THSteps D0274 0 999 $0.00 0 0 $0.00 $17.66 Dental/Orthodontia W THSteps D0277 0 999 $0.00 0 0 $0.00 $31.75 Dental/Orthodontia W THSteps D0290 0 999 $0.00 0 0 $0.00 $33.75 Dental/Orthodontia W THSteps D0310 0 999 $0.00 0 0 $0.00 $45.00 Dental/Orthodontia W THSteps D0320 0 999 $0.00 0 0 $0.00 $75.00 Dental/Orthodontia W THSteps D0321 0 999 $0.00 0 0 $0.00 $35.00 Dental/Orthodontia W THSteps D0322 0 999 $0.00 0 0 $0.00 $33.75 Dental/Orthodontia W THSteps D0330 0 999 $0.00 0 0 $0.00 $32.54 Dental/Orthodontia W THSteps D0340 0 999 $0.00 0 0 $0.00 $33.75 Dental/Orthodontia W THSteps D0350 0 999 $0.00 0 0 $0.00 $18.75 Dental/Orthodontia W THSteps D0415 0 999 $0.00 0 0 $0.00 $25.00 Dental/Orthodontia W THSteps D0460 0 999 $0.00 0 0 $0.00 $12.50 Dental/Orthodontia W THSteps D0470 0 999 $0.00 0 0 $0.00 $22.50 Dental/Orthodontia W THSteps D0502 0 999 $0.00 0 0 $0.00 $57.50 Dental/Orthodontia W THSteps D0999 0 999 $0.00 0 0 $0.00 $0.00 Dental/Orthodontia W THSteps D1110 0 999 $0.00 0 0 $0.00 $28.00 Dental/Orthodontia Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

Note Code

5

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

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Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D1120 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1203 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1204 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1330 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1351 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1510 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1515 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1520 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1525 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D1550 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2140 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2150 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2160 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2161 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2330 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2331 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2332 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2335 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2390 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2391 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2392 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2393 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2394 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2410 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2420 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2430 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2510 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2520 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2530 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2542 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2543 0 999 $0.00 0 0 Dental/Orthodontia

$18.75 $7.50 $7.50 $12.50 $14.41 $80.00 $118.75 $75.00 $106.25 $18.75 $32.86 $43.73 $55.71 $60.04 $39.67 $52.57 $68.64 $85.19 $150.00 $42.04 $55.10 $67.45 $75.06 $75.00 $125.00 $125.00 $181.25 $264.00 $264.00 $264.00 $264.00

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

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Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D2544 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2610 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2620 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2630 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2642 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2643 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2644 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2650 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2651 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2652 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2662 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2663 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2664 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2710 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2720 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2721 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2722 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2740 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2750 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2751 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2752 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2780 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2781 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2782 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2783 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2790 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2791 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2792 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2794 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2910 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2915 0 999 $0.00 0 0 Dental/Orthodontia

$264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $18.75 $18.75

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

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Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D2920 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2930 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2931 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2932 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2933 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2934 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2940 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2950 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2951 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2952 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2953 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2954 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2955 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2957 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2960 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2961 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2962 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2980 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D2999 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3110 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3120 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3220 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3230 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3240 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3310 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3320 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3330 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3346 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3347 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3348 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3351 0 999 $0.00 0 0 Dental/Orthodontia

$20.00 $78.03 $81.25 $68.75 $85.51 $85.51 $20.90 $45.00 $12.50 $87.50 $43.75 $75.00 $75.00 $37.50 $112.50 $181.25 $212.50 $50.00 $0.00 $16.25 $15.00 $43.98 $38.75 $43.98 $177.99 $206.25 $312.13 $156.25 $206.25 $275.00 $75.00 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

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Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D3352 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3353 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3410 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3421 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3425 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3426 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3430 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3450 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3460 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3470 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3910 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3920 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3950 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D3999 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4210 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4211 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4240 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4241 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4245 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4249 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4260 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4261 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4266 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4267 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4270 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4271 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4273 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4274 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4275 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4276 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4320 0 999 $0.00 0 0 Dental/Orthodontia

$50.00 $100.00 $131.25 $162.50 $162.50 $75.00 $50.00 $75.00 $212.50 $125.00 $18.75 $81.25 $50.00 $0.00 $162.50 $50.00 $181.25 $55.00 $181.25 $162.50 $225.00 $67.00 $275.00 $325.00 $193.75 $206.25 $225.00 $125.00 $225.00 $225.00 $62.50 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

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Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D4321 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4341 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4342 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4355 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4381 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4910 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4920 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D4999 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5110 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5120 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5130 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5140 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5211 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5212 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5213 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5214 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5281 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5410 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5411 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5421 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5422 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5510 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5520 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5610 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5620 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5630 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5640 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5650 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5660 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5670 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5671 0 999 $0.00 0 0 Dental/Orthodontia

$100.00 $56.25 $7.00 $75.00 $30.00 $37.50 $25.00 $0.00 $375.00 $375.00 $387.50 $387.50 $275.00 $275.00 $400.00 $400.00 $250.00 $18.75 $18.75 $18.75 $18.75 $50.00 $43.75 $115.00 $56.25 $50.00 $43.75 $50.00 $62.50 $175.00 $175.00 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

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Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D5710 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5711 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5720 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5721 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5730 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5731 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5740 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5741 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5750 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5751 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5760 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5761 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5810 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5811 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5820 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5821 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5850 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5851 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5860 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5861 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5862 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5899 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5911 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5912 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5913 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5914 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5915 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5916 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5919 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5922 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5923 0 999 $0.00 0 0 Dental/Orthodontia

$137.50 $137.50 $137.50 $137.50 $81.25 $81.25 $75.00 $75.00 $118.75 $118.75 $118.75 $118.75 $200.00 $200.00 $162.50 $162.50 $37.50 $37.50 $387.50 $387.50 $162.50 $0.00 $50.00 $90.00 $875.00 $875.00 $875.00 $562.50 $1,125.00 $140.00 $337.50 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

9 of 14

Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D5924 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5925 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5926 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5927 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5928 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5929 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5931 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5932 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5933 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5934 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5935 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5936 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5937 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5951 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5952 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5953 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5954 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5955 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5958 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5959 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5960 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5982 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5983 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5984 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5985 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5986 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5987 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5988 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D5999 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6010 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6040 0 999 $0.00 0 0 Dental/Orthodontia

$437.50 $375.00 $450.00 $450.00 $450.00 $900.00 $375.00 $1,300.00 $281.25 $562.50 $562.50 $625.00 $262.50 $140.00 $843.75 $843.75 $443.75 $225.00 $225.00 $100.00 $100.00 $112.50 $162.50 $162.50 $162.50 $50.00 $131.25 $112.50 $0.00 $1,125.00 $2,000.00 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

10 of 14

Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D6050 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6055 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6056 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6057 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6080 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6090 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6095 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6100 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6199 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6210 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6211 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6212 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6240 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6241 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6242 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6245 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6250 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6251 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6252 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6545 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6548 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6720 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6721 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6722 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6740 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6750 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6751 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6752 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6780 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6781 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6782 0 999 $0.00 0 0 Dental/Orthodontia

$0.00 $300.00 $350.00 $350.00 $43.75 $137.50 $175.00 $225.00 $0.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00 $264.00

5

5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

11 of 14

Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D6783 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6790 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6791 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6792 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6920 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6930 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6940 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6950 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6970 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6972 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6973 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6975 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6976 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6977 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6980 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D6999 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7111 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7140 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7210 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7220 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7230 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7240 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7241 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7250 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7260 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7261 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7270 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7272 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7280 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7282 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7283 0 999 $0.00 0 0 Dental/Orthodontia

$264.00 $264.00 $264.00 $264.00 $135.00 $37.50 $87.50 $137.50 $100.00 $81.25 $56.25 $125.00 $50.00 $40.63 $68.75 $0.00 $8.00 $33.52 $58.75 $90.00 $120.00 $150.00 $156.25 $92.50 $137.50 $137.50 $110.00 $150.00 $62.50 $62.50 $25.00 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

12 of 14

Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D7285 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7286 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7290 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7291 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7310 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7320 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7340 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7350 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7410 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7411 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7413 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7414 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7440 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7441 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7450 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7451 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7460 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7461 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7465 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7472 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7510 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7520 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7530 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7540 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7550 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7560 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7670 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7820 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7880 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7899 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7910 0 999 $0.00 0 0 Dental/Orthodontia

$75.00 $62.50 $137.50 $50.00 $56.25 $75.00 $125.00 $250.00 $100.00 $150.00 $100.00 $150.00 $181.25 $237.50 $118.75 $162.50 $118.75 $162.50 $68.75 $160.00 $37.50 $125.00 $50.00 $100.00 $106.25 $125.00 $81.25 $81.25 $140.00 $0.00 $75.00 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

13 of 14

Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D7911 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7912 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7955 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7960 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7970 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7971 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7972 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7980 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7983 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7993 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7997 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D7999 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8050 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8060 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8080 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8210 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8220 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8660 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8670 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8680 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8690 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D8999 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9110 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9210 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9211 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9212 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9215 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9220 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9221 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9230 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9241 0 999 $0.00 0 0 Dental/Orthodontia

$81.25 $162.50 $0.00 $105.00 $112.50 $43.75 $43.75 $193.75 $162.50 $587.50 $50.00 $0.00 $340.00 $340.00 $0.00 $0.00 $0.00 $15.00 $68.10 $100.00 $20.00 $0.00 $18.75 $12.50 $18.75 $31.25 $12.50 $87.50 $31.25 $28.38 $81.25 5 5 5 5 5 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

DATE: 05/14/2007 PROGRAM: MEDICAID

TEXAS MEDICAID FEE SCHEDULETHSteps DENTAL PROVIDERS $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

14 of 14

Due to AMA/ADA copyright restrictions, CPT and CDT procedure code and modifier descriptions cannot be published W THSteps D9242 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9248 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9310 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9410 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9420 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9430 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9440 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9610 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9630 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9910 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9920 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9930 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9940 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9950 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9951 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9952 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9974 0 999 $0.00 0 0 Dental/Orthodontia W THSteps D9999 0 999 $0.00 0 0 Dental/Orthodontia

$29.02 $125.00 $15.25 $25.00 $38.00 $15.00 $31.25 $18.75 $9.00 $12.50 $50.00 $25.00 $118.75 $56.25 $37.50 $150.00 $56.25 $0.00 5

Medicaid payments for services by professional and outpatient facilities covered by this fee schedule are reduced by 2.5 percent with the exception of payments for drugs/biologicals and DME/supplies. For more information, see the note on page 1.

Information

2007 Texas Medicaid Fee Schedule PRCR407c.xls

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