Sec. 10.21.25.12. Evaluation and Management Services — Including Medication Management

A. New Patients. The Department shall reimburse for evaluation and management services for new patients, including medication management:

(1) For a problem focused history, or a problem focused examination, and straightforward medical decision making of minor complexity:

(a) OMHC ... $48.70;

(b) Physician ... $48.70;

(c) Certified registered nurse practitioner—psychiatric ... $48.70;

(2) For an expanded problem focused history, or an expanded problem focused examination, and straightforward medical decision making:

(a) OMHC ... $82.48;

(b) Physician ... $82.48;

(c) Certified registered nurse practitioner—psychiatric ... $82.48;

(3) For a detailed history, or a detailed examination, and medical decision of low complexity:

(a) OMHC ... $119.25;

(b) Physician ... $119.25;

(c) Certified registered nurse practitioner—psychiatric ... $119.25;

(4) For a comprehensive history, or a comprehensive medical examination, with medical decision making of moderate complexity:

(a) OMHC ... $181.64;

(b) Physician ... $181.64;

(c) Certified registered nurse practitioner—psychiatric ... $181.64;

(5) For a comprehensive history, or a comprehensive medical examination, with medical decision making of high complexity:

(a) OMHC ... $224.53;

(b) Physician ... $224.53;

(c) Certified registered nurse practitioner—psychiatric ... $224.53.

B. Established Patients.The Department shall reimburse for evaluation and management services for established patients, including medication management:

(1) For a history, or examination, where presenting problems are minimal, and straightforward medical decision making of minor complexity:

(a) OMHC ... $22.72;

(b) Physician ... $22.72;

(c) Certified registered nurse practitioner—psychiatric ... $22.72;

(2) For a problem focused history, or a problem focused examination, and straightforward medical decision making:

(a) OMHC ... $48.70;

(b) Physician ... $48.70;

(c) Certified registered nurse practitioner—psychiatric ... $48.70;

(3) For an expanded history, or an expanded examination, and medical decision of low complexity:

(a) OMHC ... $80.11;

(b) Physician ... $80.11;

(c) Certified registered nurse practitioner—psychiatric ... $80.11;

(4) For a detailed history, or a detailed medical examination, with medical decision making of moderate complexity:

(a) OMHC ... $117.60;

(b) Physician ... $117.60;

(c) Certified registered nurse practitioner—psychiatric ... $117.60;

(5) For a comprehensive history, or a comprehensive medical examination, with medical decision making of high complexity:

(a) OMHC ... $157.64;

(b) Physician ... $157.64;

(c) Certified registered nurse practitioner—psychiatric ... $157.64.