Fee Schedules


Applied Behavior Analysis Fee Schedule Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Applied Behavior Analysis 02/12/17
PDF
04/1/14
PDF

Anesthesia Fee Schedules Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Formula Based Anesthesia Services Current
PDF
Maternity Anesthesia 06/01/15
PDF
02/01/13
PDF


Durable Medical Equipment (DME) Fee Schedule Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
DME Enteral Nutrition Fee Schedule Current
PDF
DMEPOS Fee Schedule 01/01/17
PDF, EXCEL
01/01/16
PDF

EPSDT Fee Schedule Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
EPSDT Medicaid Fee Schedule Current
PDF
07/01/12
PDF
Fee schedule for EPSDT Health Services Current
PDF
06/30/14
PDF
EPSDT PCS Procedure Code/Rate Chart Current
PDF

Home Health Services Fee Schedule Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Home Health Services Fee Schedule 01/01/17
PDF
08/01/16 - 12/31/16
PDF

Hospice Fee Schedules Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Hospice Rates, MSA Codes and Revenue Codes for Louisiana Hospice Program 10/01/16
PDF
01/01/16
PDF


Inpatient Hospital Per Diems Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Inpatient Hospital Per Diem Listing 07/01/17
PDF
01/01/17
PDF
Out-of-State Inpatient Hospital Per Diem Listing 09/01/2013
PDF

Non-Emergency Medical Transportation (NEMT) Fee Schedules Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Public Transit 12/20/11
PDF
Non-Emergency Medical Transportation 10/01/14
PDF
12/01/10
PDF


OCDD Services Fee Schedules Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Children's Choice Waiver 06/29/16
PDF
06/30/14
PDF
EPSDT Early Intervention Services (EarlySteps) 01/01/17
PDF
01/01/14
PDF
New Opportunities Waiver 06/29/16
PDF
06/30/14
PDF
Residential Options Waiver 01/20/17
PDF
06/29/16
PDF
Supports Waiver 02/29/16
PDF
02/25/14
PDF

Other Fee Schedules Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Ambulance Fee Schedule 08/1/12
PDF
06/30/12
PDF
American Indians 638 Facilities Rates
(Provider Type 95) :
01/01/17
PDF
03/15/16
PDF
Federally Qualified Health Centers (FQHCs) Rates
(Provider Type 72)
07/01/17
PDF
07/01/16
PDF
Independent Rural Health Clinics (I-RHCs) Rates
(Provider Type 87)
07/01/17
PDF
07/01/16
PDF
Provider Based Rural Health Clinics (PB-RHCs) Rates
(Provider Type 79)
07/01/17
PDF
07/01/16
PDF



Pediatric Day Health Care Services Fee Schedule Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Pediatric Day Health Care Services Fee Schedule 09/01/16
PDF
07/01/12
PDF


Rehabilitation Services Reimbursement Fee Schedule Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Free Standing Rehabilitation Centers Fee Schedule 01/01/17
PDF, EXCEL
01/01/16
PDF

Specialized Behavioral Health Fee Schedule Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Specialized Behavioral Health 12/01/15
PDF

Take Charge Plus Fee Schedule Current
Schedule
Effective Date
Previous
Schedule
Effective Date
Archives
Take Charge Plus Fee Schedule 01/01/17
PDF, EXCEL
01/01/16
PDF


Obsolete Fee Schedules

Archived Dates
ACA: (Age 0 through age 18)
ACA: (Age 19 and Older)
EPSDT Psychological and Behavioral Services Fee Schedule
Greater New Orleans Community Health Connection
H1N1: Professional Services
H1N1: Outpatient Hospitals & ESRD
KIDMED Program Fee Schedule
Multi-Systemic Therapy Fee Schedule
Rehabilitation Services Schedule