Standard Rates
Please note these are the rates that will be applied to any CPT or Rev Code that is not specifically contracted for. If you would like to review your contracted rates, please contact MINES Provider Relations at 800-873-7138 or by email.
Rate Class | CPT/Rev Code | Description | Standard Rate |
---|---|---|---|
ABA | 97151 | Behavior identification assessment by physician or other qualified healthcare professional | $90 |
ABA | 97152 | Behavior identification supporting assessment by technician | $45 |
ABA | 97153 | Adaptive behavioral Treatment by technician | $17 |
ABA | 97154 | Group adaptive behavior treatment by protocol by technician ages 2-4 and ages 5-8 | $10 |
ABA | 97155 | Adaptive behavioral treatment with protocol modification by physician or other qualified healthcare professional | $40 |
ABA | 97156 | Family adaptive behavior treatment guidance by physician or other qualified healthcare professional | $25 |
ABA | 97157 | Multiple-family group adaptive behavioral treatment guidance by physician or other qualified healthcare professional | $50 |
ABA | 97158 | Group adaptive behavioral treatment with protocol modification by physician or other qualified healthcare professional ages 2-4 and ages 5-8 | $10 |
ABA | 0362T | Behavior identification supporting assessment by technicians | $55 |
ABA | 0373T | Adaptive behavioral treatment with protocol modification by physician or other qualified healthcare professional who is on site | $83 |
ABA | T1026 | Mental health assessment, ABA clinical management, ABA direct and indirect case supervision | $120 |
Facility | 124 | Inpatient- MH | $900 |
Facility | 126 | Detoxification | $900 |
Facility | 128 | Rehab | $800 |
Facility | 905 | Intenstive Outpatient- MH | $200 |
Facility | 906 | Intenstive Outpatient- CD | $200 |
Facility | 912 | Partial Hospitalization – MH | $500 |
Facility | 913 | Partial Hospitalization – CD | $500 |
Facility | 1001 | Residential Treatment- MH | $700 |
Facility | 1002 | Residential Treatment- CD | $700 |
Facility | H0005 | Outpatient Group | $37 |
Facility | H0015 | Intenstive Outpatient | $200 |
Facility | H0019 | Residential Treatment | $700 |
Facility | H2036 | Partial Hospitalization | $500 |
Licensed Mental Health Worker | 90785 | Interactive complexity add on | $17 |
Licensed Mental Health Worker | 90791 | Psychiatric diagnostic non medical | $80 |
Licensed Mental Health Worker | 90832 | 30 min psychotherapy | $40 |
Licensed Mental Health Worker | 90834 | 45 min psychotherapy | $60 |
Licensed Mental Health Worker | 90837 | 60 min psychotherapy | $80 |
Licensed Mental Health Worker | 90839 | 60 min psychotherapy crisis | $80 |
Licensed Mental Health Worker | 90840 | 30 min add on | $40 |
Licensed Mental Health Worker | 90846 | Family Therapy wo patient | $95 |
Licensed Mental Health Worker | 90847 | Family Therapy | $95 |
Licensed Mental Health Worker | 90853 | Group Therapy per unit | $37 |
Licensed Mental Health Worker | H0004 | Behavioral health counseling and therapy, per 15 minutes | $15 |
Licensed Mental Health Worker | H0031 | Mental health assessment, by non-physician | $10 |
Other | 90867 | TMS Assessment | $400 |
Other | 90868 | TMS Follow up | $300 |
Other | 90869 | TMS Subsequent | $350 |
Other | 93136 | Psychological or neuropsychological test Administration, first 30 min | $90 |
Other | 96116 | Neurobehavioral Testing | $125 |
Other | 96121 | Neurobehavioral Status Examination | $100 |
Other | 96130 | Psychological testing evaluation, first hour | $125 |
Other | 96131 | Psychological testing evaluation, additional hour | $75 |
Other | 96132 | Neuropsychological testing evaluation, first hour | $125 |
Other | 96133 | Neuropsychological testing evaluation, additional hour | $90 |
Other | 96137 | Psychological or neuropsychological test Administration, additional 30 min | $90 |
Other | 96138 | Psychological or neuropsychological test Administration, first 30 min | $65 |
Other | 96139 | Psychological or neuropsychological test Administration, additional 30 min | $65 |
Rate Class | CPT/Rev Code | Description | Standard Rate |
---|---|---|---|
Licensed Mental Health Worker | 96156 | Health behavior assessment or re-assessment | $25 |
Licensed Mental Health Worker | 96158 | Health behavior intervention, individual, initial 30 minutes | $35 |
Licensed Mental Health Worker | 96159 | Health behavior intervention, individual, additional 15 minutes | $10 |
Licensed Mental Health Worker | 96164 | Health behavior intervention, group, initial 30 minutes | $35 |
Licensed Mental Health Worker | 96165 | Health behavior intervention, group, additional 15 minutes | $10 |
Licensed Mental Health Worker | 96170 | Health behavior intervention, family (without the patient present), initial 30 minutes | $35 |
Licensed Mental Health Worker | 96171 | Health behavior intervention, family (without the patient present), additional 15 minutes | $10 |
Other | 96146 | Psychological and Neuropsychological Testing with Automated Administration and Scoring | $125 |
Other | H0020 | Methadone administration and/or service (provision of the drug by a licensed program); per diem | $30 |
Pres. Priv | 90785 | Interactive complexity add on | $17 |
Pres. Priv | 90792 | Psychiatric diagnostic medical | $200 |
Pres. Priv | 90833 | 30 min add on | $55 |
Pres. Priv | 90836 | 45 min add on | $70 |
Pres. Priv | 90838 | 60 min add on | $85 |
Pres. Priv | 99201 | office visit communication | $36 |
Pres. Priv | 99202 | Office Visit 20 min | $80 |
Pres. Priv | 99203 | Office Visit 30 min | $100 |
Pres. Priv | 99204 | Office Visit 45 min | $150 |
Pres. Priv | 99205 | Office Visit 60 min | $200 |
Pres. Priv | 99211 | Office Visit 5 min | $40 |
Pres. Priv | 99212 | Office Visit 10 min | $55 |
Pres. Priv | 99213 | Office Visit 15 min | $75 |
Pres. Priv | 99214 | Office Visit 25 min | $95 |
Pres. Priv | 99215 | Office Visit 40 min | $133 |
Pres. Priv | 99217 | Discharge | $100 |
Pres. Priv | 99218 | Initial Observation | $96 |
Pres. Priv | 99219 | Initial Observation | $120 |
Pres. Priv | 99220 | Initial Observation | $120 |
Pres. Priv | 99221 | hospital, initial | $100 |
Pres. Priv | 99222 | hospital, initial | $130 |
Pres. Priv | 99223 | hospital, initial | $176 |
Pres. Priv | 99231 | hospital, subsequent | $50 |
Pres. Priv | 99232 | hospital, subsequent | $100 |
Pres. Priv | 99233 | hospital, subsequent | $100 |
Pres. Priv | 99234 | hospital, intake/discharge | $100 |
Pres. Priv | 99235 | hospital, Observation, evaluation | $192 |
Pres. Priv | 99236 | hospital, Observation, evaluation | $238 |
Pres. Priv | 99238 | hospital discharge | $100 |
Pres. Priv | 99239 | hospital discharge | $176 |
Pres. Priv | 99241 | office consult | $40 |
Pres. Priv | 99242 | office consult | $40 |
Pres. Priv | 99243 | office consult | $64 |
Pres. Priv | 99244 | office consult | $96 |
Pres. Priv | 99245 | office consult | $128 |
Pres. Priv | 99251 | office consult | $60 |
Pres. Priv | 99253 | in patient initial consult | $130 |
Pres. Priv | 99254 | in patient initial consult | $176 |
Pres. Priv | 99255 | in patient initial consult | $176 |
Information & Contact
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IMPORTANT INFORMATION ABOUT CLAIMS:
Please submit all insurance related billing to Mines at:
MINES and Associates Claims
P.O. Box 270669
Littleton, CO 80127
Other contact methods:
Toll free: 800-873-7138 x4051
Claims line: 303-832-1068 x4051
Fax: 303-832-9701
To check benefits, eligibility or exclusions, please check the client’s insurance card.