Fee Schedule Updates
Posted 1/28/13; Modified 03/25/13

On January 1, 2013, HealthChoice and the Department of Corrections (DOC) updated the CPT/HCPCS, Outpatient Facility (OP), Ambulatory Surgery Center (ASC), American Society of Anesthesiologists (ASA), and American Dental Association (ADA) fee schedules. Additionally, significant fee schedule updates will become effective April 1, 2013.

HealthChoice and DOC provide fee schedule updates on January 1 of each year that reflect added, changed, and deleted codes; however, the comprehensive annual fee schedule update occurs on April 1 of each year. This allows time for the Centers for Medicare & Medicaid Services (CMS) to finalize and post its fee schedules.

The following dates have been set for all future fee schedule updates for services provided by HealthChoice and DOC Network Providers:

• January 1: Add, change, and delete codes for CPT/HCPCS, OP, ASC, and ADA
• January 1: Quarterly fee schedule addendum and other updates as necessary for CPT/HCPCS, OP, ASC, ASA, and ADA
• February 1: Add, change, and delete codes for ASA
• April 1: Comprehensive fee schedule update for CPT/HCPCS, OP, ASC, and ADA
• July 1: Quarterly fee schedule addendum and other updates as necessary for CPT/HCPCS, OP, ASC, ASA, and ADA
• October 1: Quarterly fee schedule addendum and other updates as necessary for CPT/HCPCS, OP, ASC, ASA, and ADA
• October 1: Comprehensive fee schedule update for MS-DRG and MS-DRG LTCH

As a reminder, the American Medical Association periodically changes, adds, corrects or deletes procedure codes throughout the year. When these modifications occur, HealthChoice and DOC review them as soon as possible and make any necessary changes. Additionally, EGID makes fee schedule updates on an ad hoc basis when necessary.

Fee schedule updates are reported in each issue of the Network News newsletter which is distributed quarterly to all Network Providers. Updates are also posted to the provider websites. We encourage you and your staff to reference the website of your provider network for the most recent fee schedule updates and other important information.

If you have questions, please contact the Network Management by calling 1-405-717-8790 or toll-free 1-800-543-6044. Inquiries by email should be sent to EGIDNetworkManagement@sib.ok.gov.