INPATIENT CHARGES |
Item |
JDMC Charge |
Medicaid Rate |
Room and Board |
$1,500.00 |
1065.67 |
Inpatient room and board all inclusive to include all medical care, therapy, medication and supplies. |
Self pay : Self pay rates negotiable based on JDMC policy number 6065.6 available after listed charges |
|
|
|
OUTPATIENT CHARGES |
97163 |
$ 150.00 |
$ 77.34 |
97164 |
$ 150.00 |
$ 77.34 |
97165 |
$ 150.00 |
$ 77.34 |
97167 |
$ 150.00 |
$ 81.53 |
97168 |
$ 150.00 |
$ 81.53 |
97169 |
$ 150.00 |
$ 81.53 |
92523 |
$ 200.00 |
$ 176.15 |
92610 |
$ 150.00 |
$ 78.92 |
97110 |
$ 50.00 |
$ 27.77 |
97530 |
$ 50.00 |
$ 35.21 |
92526 |
$ 50.00 |
$ 79.38 |
92507 |
$ 84.00 |
$ 72.34 |
|
|
|
OUTPATIENT NEURO CLINIC OFFICE VISITS |
NEW PATIENT 30 MINUTES 99203 |
$ 105.00 |
$ 96.11 |
NEW PATIENT 45 MINUTES 99204 |
$ 150.00 |
$ 147.84 |
NEW PATIENT 60+ MINUTES 99205 |
$ 225.00 |
$ 187.18 |
EST. PATIENT 15 MINUTES 99213 |
$ 75.00 |
$ 66.86 |
EST. PATIENT 25 MINUTES 99214 |
$ 105.00 |
$ 97.32 |
EST. PATIENT 40+ MINUTES 99215 |
$ 150.00 |
$ 131.08 |
|
|
|
Frequently used outpatient codes |
PT EVALUATION |
$ 150.00 |
$ 77.34 |
OT EVALUATION |
$ 150.00 |
$ 81.53 |
SPEECH EVALUATION |
$ 200.00 |
$ 176.15 |
FEEDING EVALUATION |
$ 150.00 |
78.92 |
PT THERAPY |
$ 50.00 |
27.77 |
OT THERAPY |
$ 50.00 |
35.21 |
SPEECH THERAPY |
$ 84.00 |
72.34 |
FEEDING THERAPY |
$ 120.00 |
79.38 |
|
|
|
Inpatient room and board all inclusive to include all medical care, therapy, medication and supplies. |