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It also notes copyright restrictions for CPT codes and provides a contact line for clarification.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/la-medicaid-epsdt-health-and-idea-related-services-fees-effective-for-dos-on-and-after-january-01-2017/330811/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/la-medicaid-epsdt-health-and-idea-related-services-fees-effective-for-dos-on-and-after-january-01-2017/330811.png","ImageObject",300,407,{"name":42,"@type":43},"\tWilliam","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-21",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the effective date range for the fees in this report?","Question",{"text":63,"@type":64},"The fees are effective for dates of service on and after January 01, 2017.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What do the report’s columns represent?",{"text":68,"@type":64},"The schedule includes service type (TS), code, description, fee amount, and a unit-billing indicator (UVS) showing when more than one unit per day may be billed.",{"name":70,"@type":61,"acceptedAnswer":71},"How are claims priced to the correct file in this fee schedule?",{"text":72,"@type":64},"The file used for pricing is determined by factors including the type of provider billing and the modifier appended to the procedure code.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},330811,1790210987,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},5909887254083,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","LAM5M136 LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEM REPORT NO: RF-0-76EP  \nRUN: 05/27/25 08:22:38 LOUISIANA DEPARTMENT OF HEALTH -BUREAU OF HEALTH SERVICES -FINANCING PAGE:  \nLA MEDICAID EPSDT HEALTH AND IDEA -RELATED SERVICES  \nFEES EFFECTIVE FOR DOS ON AND AFTER JANUARY 01, 2017  \nLEGEND  \nListed below are some aids we hope will help you understand this fee schedule . If, after reading the information below, you need further clarification of an item, please call DXC Technologies Provider Relations at 1-800-473-2783 .  \nCOLUMN 1. TS (Type Service): Definition: Files on which codes are loaded and from which claims are paid . The file to which  \na claim goes for pricing is determined by, among other things, the type of provider who is billing and by the modifier appended to the procedure code .  \nListed below is an explanation of the types of service found on this schedule .  \n12 - School Boards and Early Intervention Centers  \nCOLUMNS 2, 3 and 4. CODE, DESCRIPTION, and FEE .  \nCOLUMN 5 UVS>001: An 'X' in this column means more than one unit of service per day may be billed .  \nLAM5M136 LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEM REPORT NO: RF-0-76EP  \nRUN: 05/27/25 08:22:38 LOUISIANA DEPARTMENT OF HEALTH -BUREAU OF HEALTH SERVICES -FINANCING PAGE: 1  \nLA MEDICAID EPSDT HEALTH AND IDEA -RELATED SERVICES  \nFEES EFFECTIVE FOR DOS ON AND AFTER JANUARY 01, 2017  \nCOLUMN:  \n1 2 3 4 5  \nTS CODE DESCRIPTION FEE UVS  \n>001  \n12 H0031 MH ASSMT-NON-PHYS 10.00  \n12 H0032 MH SVC PLAN DEV -NON-PHYS 10.00  \n12 S5125 ATTD CARE SVC; 15 MINS 1.50 X  \n12 T1001 NURS ASSMT/EVAL 10.00 X  \n12 T1002 IMPLEMENTATION OF PHYSICIANS ORDERS 10.00 X  \n12 T1003 LPN SERVICE 10.00 X  \n12 T1023 PHYS SVC 10.00  \n12 T1502 MEDICATION ADMINISTRATION 10.00 X  \n12 T1502 TD MEDICATION ADMINISTRATION-RN 10.00 X  \n12 T1502 TE MEDICATION ADMINISTRATION-LPN 10.00 X  \n12 V2799 VISION ITEM/SERVICE,MISCELLANEOUS 10.00  \n12 0362T BX ID SPDG ASS, 1 TECH, W/PT 10.00 X  \n12 0373T ADAPT BX TREAT, 1 TECH, 15 MINS 10.00 X  \n12 90785 AH INTERACTIVE CPLX ADD-ON, PSYD .69 X  \n12 90785 AJ INTERACTIVE CPLX ADD-ON, LCSW 2.41 X  \n12 90785 HO INTERACTIVE CPLX ADD-ON,LPC/LMFT 2.41 X  \n12 90791 AH PSY DIAG EVAL-PSYD 21.68  \n12 90791 AJ PSY DIAG EVAL-LCSW 10.00  \n12 90791 HO PSY DIAG EVAL-LPC/LMFT 10.00  \n12 90832 AH PSYT, 30 MIN W/PT -PSYD 9.53 X  \n12 90832 AJ PSYT, 30 MIN W/PT-LCSW 10.00 X  \n12 90832 HF PSYT, 30 MIN W/PT-LAC 8.34 X  \n12 90832 HO PSYT, 30 MIN W/PT-LPC/LMFT 10.00 X  \n12 90834 AH PSYT, 45 MIN W/PT-PSYD 13.42 X  \n12 90834 AJ PSYT, 45 MIN W/PT -LCSW 10.00 X  \n12 90834 HF PSYT, 45 MIN W/PT -LAC 11.74 X  \n12 90834 HO PSYT, 45 MIN W/PT -LPC/LMFT 10.00 X  \n12 90837 AH PSYT, 60 MIN W/PT -PSYD 19.76 X  \n12 90837 AJ PSYT, 60 MIN W/PT -LCSW 10.00 X  \n12 90837 HO PSYT,60 MIN W/PT -LPC/LMFT 10.00 X  \n12 90839 AH PSYT CRISIS - 60 MIN -PSYD 10.00  \n12 90839 AJ PSYT CRISIS - 60 MIN, LCSW 10.00  \n12 90839 HO PSYT CRISIS - 60 MIN LPC/LMFT 10.00  \n12 90840 AH EACH ADDTL 30 MIN 90839, PSYD 10.00 X  \n12 90840 AJ EACH ADDTL 30 MIN 90839, LCSW 10.00 X  \n12 90840 HO EACH ADDTL 30 MIN 90839,LPC/LMFT 10.00 X  \n12 90846 FAMILY PSYCHOTHERAPY W/P PT PRESENT 22.50  \n12 90846 AF FAM PSYT W/P PT - 50 MIN, PSYCH 22.50  \n12 90846 AH FAM PSYT W/P PT - 50 MIN, PSYD 10.00  \n12 90846 AJ FAM PSYT W/O PT-50 MIN, LCSW 10.00  \n12 90846 HF FAM PSYT W/O PT-50 MIN, LAC 10.00  \nNOTE: ALL CPT CODES AND DESCRIPTIONS ARE COPYRIGHTED BY THE AMERICAN MEDICAL ASSOCIATION .  \nLAM5M136 LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEM REPORT NO: RF-0-76EP  \nRUN: 05/27/25 08:22:38 LOUISIANA DEPARTMENT OF HEALTH -BUREAU OF HEALTH SERVICES -FINANCING PAGE: 2  \nLA MEDICAID EPSDT HEALTH AND IDEA -RELATED SERVICES  \nFEES EFFECTIVE FOR DOS ON AND AFTER JANUARY 01, 2017  \nCOLUMN:  \n1 2 3 4 5  \nTS CODE DESCRIPTION FEE UVS  \n>001  \n12 90846 HO FAM PSYT W/O PT-50 MIN,LPC/LMFT 10.00  \n12 90847 FAM PSYCHOTHERAPY W/ PATIENT PRESENT 22.50  \n12 90847 AF FAM PSYT W/PT 50 MIN, PSYCH 22.50  \n12 90847 AH FAM PSYT W/PT 50 MIN, PSYD 10.00  ","cbCaisSxCksWnrvj","https://ap.wps.com/l/cbCaisSxCksWnrvj","pdf",46089,"English","# LA Medicaid EPSDT Health and IDEA -Related Services\n## Fees effective for dates of service on and after January 01, 2017\n## Legend and column definitions\n## Service and CPT code fee listings","[{\"question\":\"What is the effective date range for the fees in this report?\",\"answer\":\"The fees are effective for dates of service on and after January 01, 2017.\"},{\"question\":\"What do the report’s columns represent?\",\"answer\":\"The schedule includes service type (TS), code, description, fee amount, and a unit-billing indicator (UVS) showing when more than one unit per day may be billed.\"},{\"question\":\"How are claims priced to the correct file in this fee schedule?\",\"answer\":\"The file used for pricing is determined by factors including the type of provider billing and the modifier appended to the procedure code.\"}]","LA Medicaid EPSDT Health and IDEA -Related Services - Fees Effective for DOS on and after January 01, 2017 | PDF",1789990253,13]