Pediatric Physician Rate Increase

Effective January 1, 2015, Current Procedural Terminology (CPT┬«) codes 99201 through 99496 will be reimbursed with an enhanced rate to pediatric physicians billing fee-for-service with one of the following specialty codes: 001, 019, 023 035, 036, 037, 038, 039, 043, 049, 059, 101,102.  The Physician Evaluation and Management Fee Schedule will be amended to reflect this change. 

Providers receiving reimbursement through a Medicaid managed care plan should refer to their contract with each plan to determine whether this change will impact their reimbursement from the plan.