hospital_name last_updated_on version hospital_location hospital_address license_number|MO "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated." "Signature Psychiatric Hospital, LLC" 5/31/2024 2.0.0 "North Kansas City, Missouri" 2900 Clay Edwards Drive license_ 551-5| MO TRUE description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AETNA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_AETNA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_AETNA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_AETNA]|[plan_HMO/PPO] standard_charge|[payer_AETNA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_AETNA]|[Plan_HMO/PPO] standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_AETNA MEDICARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_ALL SAVERS]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_ALL SAVERS]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_ALL SAVERS]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_ALL SAVERS]|[plan_HMO/PPO] standard_charge|[payer_ALL SAVERS]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_ALL SAVERS]|[Plan_HMO/PPO] standard_charge|[payer_ALLWELL WELLCARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_ALLWELL WELLCARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_ALLWELL WELLCARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_ALLWELL WELLCARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_ALLWELL WELLCARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_ALLWELL WELLCARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_AMBETTER]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_AMBETTER]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_AMBETTER]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_AMBETTER]|[plan_HMO/PPO] standard_charge|[payer_AMBETTER]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_AMBETTER]|[Plan_HMO/PPO] standard_charge|[payer_BCBS FEDERAL]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS FEDERAL]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS FEDERAL]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS FEDERAL]|[plan_BLUE CROSS] standard_charge|[payer_BCBS FEDERAL]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS FEDERAL]|[Plan_BLUE CROSS] standard_charge|[payer_BCBS MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_BCBS MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_BCBS MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_BCBS MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_BCBS MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_BCBS MEDICARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_BCBS OF MO]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS OF MO]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS OF MO]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS OF MO]|[plan_BLUE CROSS] standard_charge|[payer_BCBS OF MO]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS OF MO]|[Plan_BLUE CROSS] standard_charge|[payer_BCBS OOS]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS OOS]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS OOS]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS OOS]|[plan_BLUE CROSS] standard_charge|[payer_BCBS OOS]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS OOS]|[Plan_BLUE CROSS] standard_charge|[payer_BEACON HEALTH OPTIONS]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_BEACON HEALTH OPTIONS]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_BEACON HEALTH OPTIONS]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_BEACON HEALTH OPTIONS]|[plan_HMO/PPO] standard_charge|[payer_BEACON HEALTH OPTIONS]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_BEACON HEALTH OPTIONS]|[Plan_HMO/PPO] standard_charge|[payer_CIGNA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_CIGNA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_CIGNA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_CIGNA]|[plan_HMO/PPO] standard_charge|[payer_CIGNA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_CIGNA]|[Plan_HMO/PPO] standard_charge|[payer_FREEDOM NETWORK]|[plan_COMMERCIAL]|negotiated_dollar standard_charge|[payer_FREEDOM NETWORK]|[plan_COMMERCIAL] |negotiated_percentage standard_charge|[payer_FREEDOM NETWORK]|[plan_COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_FREEDOM NETWORK]|[plan_COMMERCIAL] standard_charge|[payer_FREEDOM NETWORK]|[plan_COMMERCIAL] |methodology additional_payer_notes |[payer_FREEDOM NETWORK]|[Plan_COMMERCIAL] standard_charge|[payer_FREEDOM NETWORK]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_FREEDOM NETWORK]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_FREEDOM NETWORK]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_FREEDOM NETWORK]|[plan_HMO/PPO] standard_charge|[payer_FREEDOM NETWORK]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_FREEDOM NETWORK]|[Plan_HMO/PPO] standard_charge|[payer_GEHA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_GEHA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_GEHA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_GEHA]|[plan_HMO/PPO] standard_charge|[payer_GEHA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_GEHA]|[Plan_HMO/PPO] standard_charge|[payer_HEALTHY BLUE]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_HEALTHY BLUE]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_HEALTHY BLUE]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_HEALTHY BLUE]|[plan_MANAGED MEDICAID] standard_charge|[payer_HEALTHY BLUE]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_HEALTHY BLUE]|[Plan_MANAGED MEDICAID] standard_charge|[payer_HOME STATE HEALTH]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_HOME STATE HEALTH]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_HOME STATE HEALTH]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_HOME STATE HEALTH]|[plan_MANAGED MEDICAID] standard_charge|[payer_HOME STATE HEALTH]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_HOME STATE HEALTH]|[Plan_MANAGED MEDICAID] standard_charge|[payer_HUMANA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_HUMANA]|[plan_HMO/PPO] standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_HUMANA]|[Plan_HMO/PPO] standard_charge|[payer_HUMANA MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_HUMANA MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_HUMANA MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_HUMANA MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_HUMANA MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_HUMANA MEDICARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_LIBERTY HOSPITAL]|[plan_COMMERCIAL]|negotiated_dollar standard_charge|[payer_LIBERTY HOSPITAL]|[plan_COMMERCIAL] |negotiated_percentage standard_charge|[payer_LIBERTY HOSPITAL]|[plan_COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_LIBERTY HOSPITAL]|[plan_COMMERCIAL] standard_charge|[payer_LIBERTY HOSPITAL]|[plan_COMMERCIAL] |methodology additional_payer_notes |[payer_LIBERTY HOSPITAL]|[Plan_COMMERCIAL] standard_charge|[payer_LINECO]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_LINECO]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_LINECO]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_LINECO]|[plan_HMO/PPO] standard_charge|[payer_LINECO]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_LINECO]|[Plan_HMO/PPO] standard_charge|[payer_MEDICARE]|[plan_MEDICARE]|negotiated_dollar standard_charge|[payer_MEDICARE]|[plan_MEDICARE] |negotiated_percentage standard_charge|[payer_MEDICARE]|[plan_MEDICARE] |negotiated_algorithm estimated_amount|[payer_MEDICARE]|[plan_MEDICARE] standard_charge|[payer_MEDICARE]|[plan_MEDICARE] |methodology additional_payer_notes |[payer_MEDICARE]|[Plan_MEDICARE] standard_charge|[payer_MERITAIN]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_MERITAIN]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_MERITAIN]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MERITAIN]|[plan_HMO/PPO] standard_charge|[payer_MERITAIN]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_MERITAIN]|[Plan_HMO/PPO] standard_charge|[payer_MISSOURI MEDICAID]|[plan_MEDICAID ]|negotiated_dollar standard_charge|[payer_MISSOURI MEDICAID]|[plan_MEDICAID ] |negotiated_percentage standard_charge|[payer_MISSOURI MEDICAID]|[plan_MEDICAID ] |negotiated_algorithm estimated_amount|[payer_MISSOURI MEDICAID]|[plan_MEDICAID ] standard_charge|[payer_MISSOURI MEDICAID]|[plan_MEDICAID ] |methodology additional_payer_notes |[payer_MISSOURI MEDICAID]|[Plan_MEDICAID ] standard_charge|[payer_NORTH KANSAS CITY]|[plan_COMMERCIAL]|negotiated_dollar standard_charge|[payer_NORTH KANSAS CITY]|[plan_COMMERCIAL] |negotiated_percentage standard_charge|[payer_NORTH KANSAS CITY]|[plan_COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_NORTH KANSAS CITY]|[plan_COMMERCIAL] standard_charge|[payer_NORTH KANSAS CITY]|[plan_COMMERCIAL] |methodology additional_payer_notes |[payer_NORTH KANSAS CITY]|[Plan_COMMERCIAL] standard_charge|[payer_PRIME HEALTHCARE]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_PRIME HEALTHCARE]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_PRIME HEALTHCARE]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_PRIME HEALTHCARE]|[plan_HMO/PPO] standard_charge|[payer_PRIME HEALTHCARE]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_PRIME HEALTHCARE]|[Plan_HMO/PPO] standard_charge|[payer_QUIK TRIP]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_QUIK TRIP]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_QUIK TRIP]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_QUIK TRIP]|[plan_HMO/PPO] standard_charge|[payer_QUIK TRIP]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_QUIK TRIP]|[Plan_HMO/PPO] standard_charge|[payer_TRICARE EAST]|[plan_TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE EAST]|[plan_TRICARE] standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE EAST]|[Plan_TRICARE] standard_charge|[payer_TRICARE FOR LIFE]|[plan_TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE FOR LIFE]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE FOR LIFE]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE FOR LIFE]|[plan_TRICARE] standard_charge|[payer_TRICARE FOR LIFE]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE FOR LIFE]|[Plan_TRICARE] standard_charge|[payer_TRICARE OVERSEAS]|[plan_TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE OVERSEAS]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE OVERSEAS]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE OVERSEAS]|[plan_TRICARE] standard_charge|[payer_TRICARE OVERSEAS]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE OVERSEAS]|[Plan_TRICARE] standard_charge|[payer_TRICARE WEST]|[plan_TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE WEST]|[plan_TRICARE] standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE WEST]|[Plan_TRICARE] standard_charge|[payer_UHC MEDICAID]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_UHC MEDICAID]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_UHC MEDICAID]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_UHC MEDICAID]|[plan_MANAGED MEDICAID] standard_charge|[payer_UHC MEDICAID]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_UHC MEDICAID]|[Plan_MANAGED MEDICAID] standard_charge|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_UHC MEDICARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_UMR]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_UMR]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_UMR]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UMR]|[plan_HMO/PPO] standard_charge|[payer_UMR]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_UMR]|[Plan_HMO/PPO] standard_charge|[payer_UNITED HEALTHCARE]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_UNITED HEALTHCARE]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_UNITED HEALTHCARE]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UNITED HEALTHCARE]|[plan_HMO/PPO] standard_charge|[payer_UNITED HEALTHCARE]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_UNITED HEALTHCARE]|[Plan_HMO/PPO] standard_charge|[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN]|negotiated_dollar standard_charge|[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN] |negotiated_percentage standard_charge|[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN] |negotiated_algorithm estimated_amount|[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN] standard_charge|[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN] |methodology additional_payer_notes |[payer_VA CCN OPTUM]|[Plan_VETERANS ADMIN] standard_charge|[payer_WORK COMP]|[plan_WORKERS COMP]|negotiated_dollar standard_charge|[payer_WORK COMP]|[plan_WORKERS COMP] |negotiated_percentage standard_charge|[payer_WORK COMP]|[plan_WORKERS COMP] |negotiated_algorithm estimated_amount|[payer_WORK COMP]|[plan_WORKERS COMP] standard_charge|[payer_WORK COMP]|[plan_WORKERS COMP] |methodology additional_payer_notes |[payer_WORK COMP]|[Plan_WORKERS COMP] additional_generic_notes ROOM AND BOARD PSYCH-GERI 124 RC facility inpatient 2268 900 804 1386 945 per diem 945 per diem 948 per diem 925 per diem 1074 per diem 1074 per diem 1074 per diem 1074 per diem 875 per diem 994 per diem 1074 per diem 948 per diem 820 per diem 842 per diem 1080 per diem 900 per diem 1074 per diem 945 per diem 820 per diem 850 per diem 960 per diem 900 per diem 975 per diem 804 per diem 1386 per diem 1386 per diem 882 per diem 948 per diem 948 per diem 1000 per diem ROOM AND BOARD PSYCH-NKC 124 RC facility inpatient 2268 900 804 1386 945 per diem 945 per diem 948 per diem 925 per diem 1074 per diem 1074 per diem 1074 per diem 1074 per diem 875 per diem 994 per diem 1074 per diem 948 per diem 820 per diem 842 per diem 1080 per diem 900 per diem 1074 per diem 945 per diem 820 per diem 850 per diem 960 per diem 900 per diem 975 per diem 804 per diem 1386 per diem 1386 per diem 882 per diem 948 per diem 948 per diem 1000 per diem TRANSCRANIAL MAGNETIC STIMULATION INITIAL MAPPING 900 RC facility outpatient 648 225 237 285 259 per diem 259 per diem 237 per diem 237 per diem 237 per diem 237 per diem 285 per diem 256 per diem 259 per diem 251 per diem 285 per diem 256 per diem TRANSCRANIAL MAGNETIC STIMULATION REMAPPING 900 RC facility outpatient 540 175 216 292 216 per diem 216 per diem 292 per diem 292 per diem 292 per diem 292 per diem 285 per diem 256 per diem 216 per diem 251 per diem 290 per diem 256 per diem TRANSCRANIAL MAGNETIC STIMULATION TREATMENT 900 RC facility outpatient 432 175 148 295 173 per diem 173 per diem 148 per diem 148 per diem 148 per diem 148 per diem 285 per diem 256 per diem 173 per diem 251 per diem 295 per diem INTENSIVE OUTPATIENT PROGRAM ADOLESCENT - MPN 905 RC facility outpatient 567 175 150 285 235 per diem 235 per diem 252 per diem 225 per diem 260 per diem 260 per diem 260 per diem 260 per diem 268 per diem 273 per diem 260 per diem 252 per diem 200 per diem 180 per diem 285 per diem 173 per diem 260 per diem 235 per diem 252 per diem 235 per diem 217 per diem 214 per diem 217 per diem 214 per diem 150 per diem 225 per diem 252 per diem 252 per diem 214 per diem 275 per diem INTENSIVE OUTPATIENT PROGRAM AM NKC 905 RC facility outpatient 567 175 150 285 235 per diem 235 per diem 252 per diem 225 per diem 260 per diem 260 per diem 260 per diem 260 per diem 268 per diem 273 per diem 260 per diem 252 per diem 200 per diem 180 per diem 285 per diem 173 per diem 260 per diem 235 per diem 252 per diem 235 per diem 217 per diem 214 per diem 217 per diem 214 per diem 150 per diem 225 per diem 252 per diem 252 per diem 214 per diem 275 per diem INTENSIVE OUTPATIENT PROGRAM CD - MPN 906 RC facility outpatient 567 175 150 285 235 per diem 235 per diem 252 per diem 225 per diem 260 per diem 260 per diem 260 per diem 260 per diem 268 per diem 273 per diem 260 per diem 252 per diem 200 per diem 180 per diem 285 per diem 173 per diem 260 per diem 235 per diem 252 per diem 235 per diem 217 per diem 214 per diem 217 per diem 214 per diem 150 per diem 225 per diem 252 per diem 252 per diem 214 per diem 275 per diem PARTIAL HOSPITAL PROGRAM ADULT - LIBERTY 912 RC facility outpatient 756 225 200 470 398 per diem 398 per diem 402 per diem 380 per diem 368 per diem 368 per diem 368 per diem 368 per diem 410 per diem 426 per diem 368 per diem 402 per diem 300 per diem 300 per diem 470 per diem 200 per diem 368 per diem 398 per diem 410 per diem 375 per diem 251 per diem 253 per diem 251 per diem 253 per diem 274 per diem 350 per diem 402 per diem 402 per diem 253 per diem 375 per diem PARTIAL HOSPITAL PROGRAM BTC ADLT- NKC 912 RC facility outpatient 756 225 200 470 398 per diem 398 per diem 402 per diem 380 per diem 368 per diem 368 per diem 368 per diem 368 per diem 410 per diem 426 per diem 368 per diem 402 per diem 300 per diem 300 per diem 470 per diem 200 per diem 368 per diem 398 per diem 410 per diem 375 per diem 251 per diem 253 per diem 251 per diem 253 per diem 274 per diem 350 per diem 402 per diem 402 per diem 253 per diem 375 per diem VALOR PARTIAL HOSPITAL PROGRAM - NKC 912 RC facility outpatient 756 225 200 470 398 per diem 398 per diem 402 per diem 380 per diem 368 per diem 368 per diem 368 per diem 368 per diem 410 per diem 426 per diem 368 per diem 402 per diem 300 per diem 300 per diem 470 per diem 200 per diem 368 per diem 398 per diem 410 per diem 375 per diem 251 per diem 253 per diem 251 per diem 253 per diem 274 per diem 350 per diem 402 per diem 402 per diem 253 per diem 375 per diem PARTIAL HOSPITAL PROGRAM CD ADULT - NKC 913 RC facility outpatient 756 225 200 470 398 per diem 398 per diem 380 per diem 410 per diem 426 per diem 402 per diem 300 per diem 300 per diem 470 per diem 200 per diem 398 per diem 410 per diem 375 per diem 251 per diem 253 per diem 251 per diem 253 per diem 274 per diem 350 per diem 402 per diem 253 per diem INTENSIVE OUTPATIENT PROGRAM ADOLESCENT GRP1 915 RC facility outpatient 189 225 200 426 398 per diem 398 per diem 426 per diem 200 per diem 398 per diem 410 per diem 375 per diem 251 per diem 251 per diem 253 per diem 253 per diem INTENSIVE OUTPATIENT PROGRAM BCI PROCESS GRP1 915 RC facility outpatient 189 225 200 426 398 per diem 398 per diem 426 per diem 200 per diem 398 per diem 410 per diem 375 per diem 251 per diem 251 per diem 253 per diem 253 per diem INTENSIVE OUTPATIENT PROGRAM DUAL EVE GRP1 915 RC facility outpatient 189 225 200 426 398 per diem 398 per diem 426 per diem 200 per diem 398 per diem 410 per diem 375 per diem 251 per diem 251 per diem 253 per diem 253 per diem INTENSIVE OUTPATIENT PROGRAM DUAL EVE TH GRP1 915 RC facility outpatient 189 225 200 426 398 per diem 398 per diem 426 per diem 200 per diem 398 per diem 410 per diem 375 per diem 251 per diem 251 per diem 253 per diem 253 per diem INTENSIVE OUTPATIENT PROGRAM VALOR TH GRP3 915 RC facility outpatient 189 225 200 426 398 per diem 398 per diem 426 per diem 200 per diem 398 per diem 410 per diem 375 per diem 251 per diem 251 per diem 253 per diem 253 per diem PARTIAL HOSPITAL PROGRAM BTC GRP1 TH 915 RC facility outpatient 189 225 200 426 398 per diem 398 per diem 426 per diem 200 per diem 398 per diem 410 per diem 375 per diem 251 per diem 251 per diem 253 per diem 253 per diem ROOM AND BOARD CD RESIDENTIAL 1002 RC facility inpatient 1080 650 525 675 661 per diem 670 per diem 525 per diem 593 per diem 593 per diem 593 per diem 600 per diem 651 per diem 593 per diem 670 per diem 650 per diem 593 per diem 675 per diem 670 per diem 670 per diem "Initial hospital inpatient or observation care, per day, moderate medical decision making" 99222 RC facility both 200 88 200 120 fee schedule 120 fee schedule 115 fee schedule 120 fee schedule 200 fee schedule 138 fee schedule 111 fee schedule 111 fee schedule 100 fee schedule 94 fee schedule 88 fee schedule 163 fee schedule 109 fee schedule 116 fee schedule 111 fee schedule 96 fee schedule 134 fee schedule 122 fee schedule 112 fee schedule "Initial hospital inpatient or observation care, per day, high-level medical decision making" 99223 RC facility both 204 65 190 177 fee schedule 177 fee schedule 115 fee schedule 190 fee schedule 158 fee schedule 163 fee schedule 163 fee schedule 140 fee schedule 158 fee schedule 135 fee schedule 65 fee schedule 73 fee schedule 143 fee schedule 163 fee schedule 130 fee schedule 159 fee schedule 164 fee schedule 171 fee schedule "Subsequent hospital inpatient or observation care, per day, moderate medical decision making 35 Mins" 99232 RC facility both 105 53 80 80 fee schedule 80 fee schedule 69 fee schedule 70 fee schedule 65 fee schedule 72 fee schedule 58 fee schedule 58 fee schedule 61 fee schedule 67 fee schedule 53 fee schedule 69 fee schedule 59 fee schedule 59 fee schedule 66 fee schedule 62 fee schedule 69 fee schedule Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter 99238 RC facility both 135 26 89 81 fee schedule 81 fee schedule 67 fee schedule 70 fee schedule 89 fee schedule 59 fee schedule 59 fee schedule 69 fee schedule 26 fee schedule 72 fee schedule 71 fee schedule 59 fee schedule 89 fee schedule 69 fee schedule 65 fee schedule 80 fee schedule