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Home My WebLink About20173968.tiffRESOLUTION RE: APPROVE REVISIONS TO FEE SCHEDULE FOR FEES COLLECTED BY THE WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with revisions to the fee schedule for fees collected by the Weld County Department of Public Health and Environment, and WHEREAS, after study and review, the Board deems it advisable to approve the proposed revisions, effective January 1, 2018, copies of which are attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the revised fee schedule for fees collected by the Weld County Department of Public Health and Environment, as attached hereto, be, and hereby are, approved, effective January 1, 2018. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 27th day of November, A.D., 2017. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: .,d ,) Weld County Clerk to the Board y Clerk to the Board ounty Attorney Date of signature: to (7( CG HLC TCC) oc(I'at I8 Julie A. Cozad, Chair can P. Conway r _ 2017-3968 HL0003 Memorandum TO: Julie A. Cozad, Chair Board of County Commissioners FROM: Mark E. Wallace, MD, MPH Executive Director Department of Public Health & Environment DATE: November 20, 2017 SUBJECT: Proposed 2018 Fee Schedule Increases For the Board's review and approval are the Health Department's proposed Environmental Health Services ("EHS") and Public Health Clinical Services ("PHCS") fees schedules for 2018. Both a strike -through version and the final versions of each are attached to aid in the Board's review. ENVIRONMENTAL HEALTH SERVICES: A detailed review of the EHS fee schedule was made to ensure that costs are adequately recovered across all sections of the EHS division. Twelve lab test fees were increased in order to align with providers of similar services. New lab fees were added for the testing of HPV, HPV Genotyping, Chlorite and after-hours STAT individual test results. Retail Food Establishment license fees were updated again this past September to allow for the second phase of the statutory fee increase. A late fee was added to the temporary event license coordinator and vendor fee schedule to allow for the accommodation that must be made by staff when applications are submitted after the due dates (the temporary event fees are now controlled locally). A plan review application fee (non-refundable) was added to the Child Care Center Fees since at times plans are submitted and reviewed but the project doesn't come to fruition, leaving staff expenditure of time unreimbursed. Other Consumer Protection programs already have an application fee in their fee schedules. Radon test and mailed radon test fees were increased by $1.00 each but this is a service that is typically covered by a grant. The fees would apply only if the grant became unavailable. No changes were made to the EHS Household Hazardous Waste fee schedule. PUBLIC HEALTH CLINICAL SERVICES: A detailed review of the PHCS fee schedule was made to ensure that costs are adequately recovered across all clinic programs of the PHCS division. All fees were reviewed to establish that the Health Department is charging at least the Medicare reimbursement rate for all services provided at the Health Department. For services that are not covered by Medicare, the Medicaid reimbursement rate was used as a reimbursement floor. Consistent with prior year fee schedule adjustments, following that comparison and after making increases where appropriate, we increased our fees for all services and supplies by 3% across- the-board. Again, this fee increase request is a modest increase compared to the medical rate of inflation which is anticipated to be remain consistent at approximately 6.5% in 2018. Several services were added to the fee schedule to provide more comprehensive care for our clinic patients. These proposed fee schedules were approved for placement on the Board's agenda via pass - around dated November 20, 2017. I recommend approval of the 2018 PHCS and EHS fee schedule increases. 1► r a"7 2017-3968 UL f'bb 3 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE 2018 Proposed HOUSEHOLD CODE SEE Code Code Code Code Code Code P■ cedure Ll 2 3 4 5:00 p99201 Minimal 0.00 12.50 25.00 37.50 50.00 99202 99203 Expanded* Detailed* Comprehensive* Es hbll Shed Cloent Minimal* 99212 Focused* 99213 xpanded* 0.00 0.00 29.25 38.00 24.75 49.50 87.75 114.00 170.25 33.75 57.00 74.25 117.00 152.00 227.00 76.00 99.00 99214 Detailed* 0.00 39.00 78.00 117.00 156.00 Home Visits 99341 New Client - Focused 92.00 92.00 92.00 92.00 92.00 99342 N ew Client - Expanded 92.00 92.00 92.00 92.00 92.00 99347 Est. Client - Focused d 92.00 92.00 92.00 92.00 92.00 99348 99401 99402 99403 Travel Visits 99404 99401W 99412 Est. Client - Expanded 92.00 Preventiv edicine Coun s&hig (Family Planning) individual - 15 min individual - 30 min* Individual Initial Visit - 60 eturn Visit Group Initial isit (per person) - 60 0.00 0.00 92.00 12.00 17.25 0.00 124.00 57.00 57.00 24.00 124.00 57.00 57.00 92.00 24.00 34.50 48.00 124.00 124.00 124.00 57.00 57.00 92.00 36.00 51.75 72.00 57.0O 57.00 96.00 48.00 69.00 96.00 57.00 57.00 Prevent ve Medicine t N 99384 blew Client 12-17 years old* 0.00 38.00 76.00 114.00 152.00 99385 I New Client 18-39 years old* 1 0.00 38.00 76.0O 114.0O 152.00 99386 N ew Client 40-64 years old* 0.00 41.25 82.50 123.75 165.00 99394 Est. Client 12-17 years old* p 0.QQI 32.00 64.00 96.00 128.00 99395 Est. Client 18-39 years old* 0.00 32.75 65.50 98.25 131.00 99396 Est. Client 40-64 years old* I 0.00] 34.75 69.50 104.25 139.00 oonal Codes 10071W (Community Education 1 hr. 74.001 74.00I 74.00 74.00 74.0O 0069W G9006 56420 Travax Printout N HV Mother - Task Care Management N H Child - Task Care Management I Exam pre -pay -NP Wellness Package TB Consultation Bartholin Cyst 15.00 15.00 15.00 15.00 193.00 0.00 15.00 15.00 15.00 15.00 15.00 15.00 15.00 193.00 0.00 15.00 193.00 0.00 15.00 15.00 15.00 15.00 193.00 0.00 15.00 15.00 15.00 193.00 49.00 45.00 140.00 11100 Biopsy of skin, single 0.00 0.00 0.00 0.00 118.00 57500 0116W 57452 Cervical Lesion Biopsy Chest X -Ray (Prepay) Colposcopy without Biopsy ** 147.00 126.00 147.00 126.00 147.00 67.00 126.00 147.00 67.00 126.00 147.00 67.00 126.00 Revised 11/09/2017 1of7 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE 57454 Colposcopy with Biopsy ** 176.00 176.00 176.00 176.00 176.00 57511 Cryocautery cervix- initial or repeat 167.00 167.001 167.00 167.00 167.00 17000 Cryotherapy first lesion* 77.00 77.00 77.00 77.00 77.00 17003 Cryotherapy 2-14 lesions** 7.00 7.00 7.00 7.00 7.00 17004 Cryotherapy 15 + lesions** 173.00 173.00 173.00 173.00 173.00 56501 Destruction Lesion Vulva 150.00 150.00 150.00 150.00 150.00 57170 Diaphragm/Cervical Cap Fitting* 0.00 23.75, 47.50 71.25 95.00 58100 Endometrial biopsy w/wo Biopsy 126.00' 126.00 126.00 126.00 126.00 58110 Endometrial biopsy with Colposcopy 68.00 68.00 68.00 68.00 68.00 Essure by referral*** 0.00 0.00r 0.00 0.00 0.00 11400 Excisions, benign lesion 142.00 142.00' 142.00 142.00 142.00 1.1981 Implanon Insertion* 0.00 49.00 98.00 147.00 196.00 10060 Incision simple & drainage of abcess, single or 135.00 135.00 135.00 135.00 135.00 58300 Insertion IUD* 0.00 i 49.25 98.50 147.75 197.00 57460 LEEP with biopsy 324.00 324.00 324.00 324.00 324.00 57461 LEEP with conization 368.00 368.00 368.00 368.00 368.00 88305 Level 4 - Surgical pathology 1st site 108.00 108.00 108.00 108.00 108.00 _ - 88305W Level 4 - Surgical Pathology 2nd site & each add! 108.00 108.00 108.00 108.00 108.00 59025 Non Stress Test Interp 0.00 0.00 0.00 0.00 0.00 11976 Removal, implant contraceptive (Irnplanon)*4 0.00 58.25 116.50 174.75 233.00 11983 Removal implant, with reinsertion* 0.00 89.25 178.50 267.75' 357.00 58301 Removal IUD* 0.00 39.50 79.00 118.50 158.00' A4550 Surgical Tray 71.00 71.00 71.00 71.00 71.00 11300 Shaving arms or of legs, epidermal .5cm lesion, single on trunk, 111.00 111.00 111.00 111.00 111.00 76857 Ultrasound - pelvic non -obstetric 76.00 76.00 76.00 76.00 76.00 FAMILY PLANNING SUPPLIES A4267 Condoms pkg 10* I 0.00 1.75 3.50 5.25 7.00 0052W Cycle Beads* 0.00 3.75 7.50 11.25 15.00 A4266 Diaphragm* 0.00 8.25 16.50 24.75 33.00 IA4269 Foam Contraception* 0.00 4 3.00 6.00 9.00 12.00 J7307 Nexplanon (Etonogestrel)* 0.00 210.50 421.00 631.50 842.00 J7306 Levonorgestrel 0.00 210.50 421.00 631.50 842.00 J7298 IUD Mirena* 0.00 241.50 483.00 724.50 966.00 J7300 IUD Paragard* 0.00 200.75 401.50 602.25 803.00 J7301 IUD Skyla* 0.00 224.00 448.00 672.00 896.00 J7297 IUD Liletta 0.00' 164.25 328.50 492.75 657.00 Q9984 IUD Kyleena 0.00 143.75 287.50 431.25 575.00 _ J1050 Medroxyprogesterone 150mg IM (Depo)* 0.00 18.25 36.50 54.75 73.00 96372 Admin fee depo- if visit for injection only 0.00 7.25 14.50 21.75 29.0O J7303 Nuva Ring* 0.004 10.75 21.50 32.25 43.00 S4993 Oral Contraceptives* 0.00 7.75 15.50 23.25 31.00 0068W Seasonale* 0.00 18.25' 36.50 54.75 _ 73.00 0065W Today's Sponge* 0.00 1.25 2.50 3.00 5.00 LAB 86900 ABO blood typing 0.00 1.25 2.50 3.75 ' 5.00 82947 Assay, body fluid, glucose, (FBS)* 0.00 5.50 11.00 16.50 22.00 85025 CBC w/Diff 23.00 23.00 23.00 23.00 23.0O 85027 CBC w/o Diff 20.00 20.00 20.00 20.00 20.00 87491 Chlamydia PCR* 0.00 25.00 37.50 50.00 12.50 Revised 11/09/2017 2of7 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE 87491 NS 80053 0090W 82627 83001 87591 87591 NS 82948 82951 Chlamydia PCR* - full fee Comprehensive Metabolic Panel Court Ordered Lab Draw DHEAS FSH Gonorrhea PCR* Gonorrhea PCR* - full fee Glucose Random Glucose Tolerance Test 2 hr (GTT) 87205 Gram Stain 84702 84703 83718 86706 87255 86695 86696 85018 83036 86701 86702 86703 87389 G0435 87624 87625 0081W 484006W 87254 83525 83002 80061W 80061 N 80076 86790 80048 86376 82274 88142 0080W 88175 88141 84146 86901 87535 86592 87798 87081 84480 84481 84436 84439 84403 82465 87661 HCG Quantitative - Serum Pregnancy Test HCG Qualitative - Serum Pregnancy Test HDL Cholesterol Hep B Surface Antibody Herpes Culture Herpes Select - Type I (89999A33) Herpes Select - Type II (89999A33) HGB - (Finger Stick)* HGB Al c HIV 1/2 AB Diff (this is HIV 1) HIV 1/2 AB Diff (this is HIV 2) HIV Screen, ELISA HIV - 1 antigen w/ HIV -1 & HIV -2 HIV Screen, Rapid Test HPV, High Risk HPV typing 16,18,45 HPV, High Risk wl repeat pap (LabCorp use) Immunohistochemical Stain 50.00 14.00 16.00 31.00 38.00 0.00 50.00 8.00 27.00 29.00 44.00 44.00 33.00 76.00 76.00 0.00 36.00 12.00 13.00 26.00 26.00 26.00 76.00 47.00 121.00 109.00 Influenza - Viral Culture i 46.00 Insulin, Fasting LH Lipid Pan& - SFS* Lipid Panel Liver Panel MAC Elisa Metabolic Panel Microsomal antibodies Occult Blood Test, Fecal, IA* Pap - Thin Prep* Pap, repeat thin prep Pap, Thin prep, w HR HPV, Reflex 16,18.45 Physician Read Pap Prolactin RH blood type RNA Qaul. RPR/Syphillis test RT-PCR comprehensive- serum and urine Streptococcus - Hemolytic 9.00! 15.00 38.00 0.00 40.00 32.00 132.00 33.00 18.00 31.00 0.00 46.00 123.00 37.00 40.00 0.00 47.00 25.00 686.00 50.00 14.00 16.00 50.00 14.00 16.00 31.00 31.00 38.00 12.00 8.00 27.00 29.00 44.00 44.00 33.00 76.00 3.50 36.00 12.00 13.00 26.00 26.00 26.00 76.00 47.00 121.00 109.00 46.00 15.00 38.00 10.00 40.00 32.00 132.00 33.00 18.00 31.00 11.50 46.00 123.00 37.00 40.00 1.75 47.00 25.00 686.00 9. 9.00 T3 Triiodothyronine TT -3 (Free -Unbound) T4 Thyroxine T4 (Total Free -Unbound) Testosterone, Total Total Cholesterol Trichomonas vaginalis - amplified 49.00 49.00 9.00 11.00 36.00 24.00 46.00 49.00 49.00 9.00 11.00 36.00 24.00 46.00 38.00 24.00 50.00 8.00 27.00 29.00 44.00 44.00 33.00 26.00 76.00 76.00 76.00 7.00 36.00 12.00 13.00 26.00 26.00 26.00 76.00 47.00 121.00 109.00 46.00 15.00 38.00 20.00 40.00 32.00 132.00 33.00 18.00 31.00 23.00 46.00 123.00 37.00 40.00 3.50 47.00 25.00 686.00 9.00 49.00 49.00' 9.00 11.00 36.00 24.00 46.00 50.00 14.00 16.00 31.00 38.00 36.00 50.00 8.00 27.00 29.00 50.00 14.00 16.00 31.00 38.00 50.00 50.00 8.00 27.00 29.00 44.00 44.00 44.00 33.00 76.00 76.00 44.00 33.00 26.00 76.00 76.00 76.00 10.501 14.00 36.00 12.00 13.00 26.00 26.00 26.00 76.00 47.00 121.00 109.00 46.00 15.00 38.00 30.00 40.00 36.00 12.00 13.00 26.00 26.00 26.00 76.00 47.00 121.00 109.00 46.00 15.00 38.00 40.00 40.00 32.001 32.00 132.00 33.00 18.00 31.00 132.00 33.00 18.00 31.00 34.501 46.00 46.00 123.00 37.00 40.00 5.25 47.00 25.00 686.00 9.00 49.00 46.00 123.00 37.00 40.00 7.00 47.00 25.00 686.00 9.00 49.00 49.001 49.00 9.00 11.00 9.00 11.00 36.001 36.00 24.00 46.00 24.00 46.00 Revised 11/09/2017 3of7 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE 84443 86480 81001 81002 87086 81025 36415 36415W 36416 36416W 96372 87210 0020W 0062W 101456W 0456W J0696 0696W 0007W 0058W TSH Tuberculosis Test-Quantiferon (IGRA) U rinalysis, complete with micro ex U rinalysis, w/o scope (UA) U rine Culture, Comprehensive U rine Preganancy Test* Venipuncture Venipuncture with sliding fee lab Venipuncture - capillary blood specimen Venipuncture - capillary blood specimen Admin fee for Depo and antibiotics Wet Prep MEDICINES and TREATMENTS Amoxicillin 875 mg #20 Azythromycin, Z pack Azithromycin 1 g - partner pack Azithromycin State supplied Ceftriaxone 250 mg Ceftriaxone 250 mg State Supplied Cephalexin 500 mg #14 Ciprofloxcin 500 mg #6 36.00 96.00 7.00 10.00 11.00 0.00 6.00 0.00 6.00 0.00 0.00 26.00 16.00 16.00 11.00 0.00 34.00 0.00 10.00 16.00 36.00 96.00 7.00 10.00 11.00 3.75 6.00 1.50 6.00 1.50 7.25 26.00 36.00 96.00 7.00 10.00 11.00 7.50 6.00 3.00 6.00 3.00 14.50 26.00 36.00 96.00 7.00 10.00 11.00 11.25 6.00 4.50 6.00 4.50 21.75 26.00 16.00 16.00 16.00 16.00 11.00 0.00 0.00 0.00 10.00 16.00 11.00 0.00 0.00 0.00 10.00 16.00 11.00 0.00 0.00 0.00 10.00 36.00 96.00 7.00 10.00 11.00 15.00 6.00 6.00 6.00 6.00 29.00 26.00 16.00 16.00 11.00 0.00 34.00 0.00 10.00 16.00 16.00 16.0 0035W Condylox 10.00 10.00 10.00 10.00 10.00 oxycycline 100 mg #14 0059W 0011W Estradiol 1 mg- #100 Fluconazole 150 mo #1 11.00 16.00 23.00 11.00 11.00 16.00 23.00 16.00 11.00 16.00 23.00 2 11.00 16.00 0012W Iron i 12.00 12.00 12.00 12.00 12.00 0060W 0008W 0009W 0010W 0013W 0006W 0016W 0004W 00180W 00180NC 90471 90472 90473 90700N 90700 90702N 90633N 90633 90632N 90632 90744N 90744 90746N 90746 icillin 2.4 Units Medroxyprogesterone 10 mg - #5 Metrogel Metronidazole 500 mg #4 Metronidazole 500 mg #14 Metronidazole 250 mg #28 Misoprostel (Cytotec) 200 mcg #2 Podophyllin/TCA Sulfatrim SMX/TMP Suprax 400 mg #1 - partner pak Suprax 400 mg #1 - State Supplied lmm. Admin - one vaccine Imm Admin - each addl. Vaccine Imm Admin - intranasal or oral DTaP -State supplied DTaP DT - State supplied Hepatitis A - Child - State supplied Hepatitis A - Child Hepatitis A - Adult - State supplied Hepatitis A - Adult Hepatitis B - Child - State supplied Hepatitis B - Child Hepatitis B - Adult - State supplied Hepatitis B - Adult 16.00 10.00 10.00 15.00 15.00 10.00 16.00 10.00 29.00 0.00 29.00 29.00 29.00 0.00 32.00 0.00 0.00 34.00 0.00 90.00 0.00 29.00 0.00 83.00 16.00 10.00 10.00 15.00 15.00 10.00 16.00 10.00 29.00 0.00 29.00 29.00 29.00 0.00 32.00 0.00 0.00 34.00 0.00 90.00 0.00 29.00 0.00 83.00 16.00 10.00 10.00 15.00 15.00 10.00 16.00 10.00 29.00 0.00 29.00 29.00 29.00 0.00 32.00 0.00 0.00 34.00 0.00 90.00 0.00 29.00 0.00 83.00 5.00 16.00 10.00 10.00 15.00 15.00 10.00 16.00 10.00 29.00 0.00 29.00 29.00 29.00 0.00 32.00 5.00 16.00 10.00 10.00 15.00 15.00 10.00 16.00 10.00 29.00 0.00 29.00 29.00 29.00 0.00 32.00 0.001 0.00 0.00 34.00 0.00 90.00 0.00 29.00 0.00 83.00 0.00 34.00 0.00 90.00 0.00 29.00 0.00 83.00 Revised 11/09/2017 4of7 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE 90647N 90647 HI State supplied HIB 0.00 90651N PTV 9 - State suoolied 0.00 0.00 38.00 0.00 0.00 38.00 0.00 0.00 38.00 0.00 0.00 38.00 0.00 90651 H PV 9 I 184.00 184.00 P 184.00 184.00 184.00 90281 90660N 90660 90687 90687N 90688 90688N IG Hepatitis A - State supplied Influenza - intranasal use - State supplied Influenza - Intranasal Adult Influenza - infant quadrivalent Influenza - infant quadrivalent - State supplied Influenza - 3 yrs and up - quadrivalent Influenza - 3 yrs and up - State supplied quadrival 0.00 0.00 36.00 0.00 0.00 36.00 0.00 0.00 0.00 36.00 36.00 0.00 36.00 0.00 0.00 36.00 0.00 0.00 0.00 36.00 36.00 0.00 I90713N IPV-VFC - State supplied I 0.001 0.001 0.001 0.00 I 0.00 90713 90738 90696N 90696 90734N 90620 90733 90707N IPV Japanese Encephalitis (new formulation) Kinrix - (DTaP/IPV)/Quadracel - State supplied Kinrix - (DTaP/IPV)/Quadracel MCV4 - State supplied MPSV1 (Menomune)(polysaccharide) MMR - State supplied 70.00 318.00 70.00 318.00 169.00 169.00 90707 90723N 90723 90698N Pediarix (DTAP, IPV, Hep B) - State supplied Pediarix - (DTaP/IPV/Hep B) Pentacel - (DTaP/IPV/HepB - State supplied 62.00 169.00 169.00 0.00 0.00 70.00 318.00 0.00 62.00 0.00 169.00 161.00 70.00 318.00 62.00 169.00 161.00 169.007 169.00 0.00 71.00 0.00 87.00 0.00 0.00 87.00 0.00 70.00 318.00 0.00 62.00 0.00 169.00 161.00 169.00 0.00 71.00 0.00 87.00 0.00 90698 Penfacel - (DTaP/IPV/NepB) 128.00 128.00 128.00 128.00 128.00 90732N 90732 90710N 90710 90670N 90670 90675 90675N 90375 90680N 90680 90714N 90714 90715N 90715 Pneumovax - State supplied Pneumovax Proquad - MMR-Varicella Proquad - MMR-Varicella Prevnar - (PCV13) Rabies IM RIG (rabies) - per cc Rotavirus - State supplied otavirus - (RV5) Td - State supplied Tdap - State supplied Tdao - 0.00 197.00 188.00 0.00 241.00 0.00 97.00 0.00 57.00 0.00 111.00 0.00 87.00 0.00 197.00 188.00 0.00 241.00 0.00 97.00 0.00 57.00 0.00 111.00 0.00 87.00 0.00 197.00 0.00 188.00 270.00 0.00 241.00 0.00 97.00 0.00 57.00 0.00 111.00 0.00 87.00 197.00 188.00 270.00 0.00 241.00 0.00 97.00 0.00 57.00 0.00 111.00 0.00 87.00 0.00 197.00 188.00 270.00 0.00 241.00 0.00 97.00 0.00 111.00 86580 Tuberculosis Interdermal Skin Test (PPD) 49.00J 49.00 49.00 49.001 49.0O 90636 90691 90690 90716N 90716 90717 INC 99212 59425 59426 99402W Twinrix - Hep A & Hep B Typhoid - 1 Shot Typhoid - Oral Varivax - State supplied Varivax Yellow Fever Miscellaneous Service Includes Follow-up Care Antepartum are 1 visit Antepartum care 4-6 visits Antepartum care 7 or more visits PE stablishing Medical Record 122.00 79.00 69.00 0.00 122.00 156.00 0.00 76.00 677.00 1391.00 66.00 122.00 79.00 69.00 0.00 122.00 156.00 0.00 76.00 677.00 1391.00 66.00 122.004 79.00 69.00 0.00 122.00 156.00 0.00 76.00 677.00 1391.00 66.00 122.00 79.00 69.00 0.00 122.00 156.00 0.00 76.00 677.00 1391.00 66.00 122.00 79.00 69.00 0.00 122.00 156.00 0.00 76.00 677.00 1391.00 66.00 Revised 11/09/2017 5of7 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE 0255W Phone visit 0.00 0.00 0.00 0.00 0.00 59430 Post Partum Only 216.00 216.00 216.00 216.00 216.00 H1005 Prenatal Plus (1-4 visits) 197.00 197.00 197.00 197.00 197.00 H1005 Prenatal Plus (5-9 visits) 523.00 523.00 523.00 523.00 523.00 H1005 Prenatal Plus (10 visits) 983.00 983.00 983.00 983.00 983.00 H1005 Prenatal Plus (11 or more visits) 1113.00 1113.00 1113.00 1113.00 1113.00 * Fees only slide for the Family Planning Program. Charges for all other programs are the Code 5 fee. ** Services include surgical procedure only. *** These items are for referral 11/8/2017 revised Revised 11/09/2017 6 of 7 2018 HHW Facility - CESQG Fees fl4taste Type Cost per eoota tso - rj Acid gallon $9.80 5 gallon $52.00 55 gallon $311.85 $1.30/ pound 55 gallon, bulk $376.20 Aerosol (paint, pesticide) $1.20/ pound Antifreeze $0.60/ gallon Base gallon $9.80 .. . $1.30/ pound 5 gallon $52.00 55 gallon $311.85 55 gallon, bulk $376.20 Battery (excluding alkaline) rv. 50.25/ pound Battery (alkaline) " " $1.20/ pound Compressed Gas Cylinders (small) tank $3.10 Compressed Gas Cylinders (large) tank $19.30 Cyanide Compounds quart $12.05 gallon $48.20 5 gallon $241.00 Drum Handling Fee drum $15.00 Flammable Liquid (bulkable) 55 gallon drum $149.60 $0.35/ pound Flammable Liquid quart $0.55 $1.20/ pound if < quart or loose -pack gallon $$2.30 5 gallon $16.20 Fluorescent Bulbs linear foot $0.15 Fluorescent Bulbs, Compact (small) Fluorescent (large) or Sodium Bulbs small bulb $0.25 Bulb $1.35 Filter, oil $0.1.5/ pound Grease 30 gallon $147.55 Mercury thermometer $0.75 `,0.50/ pound Motor Oil (used) or Cooking Oil $0.25/ gallon `. Motor Oil Testing $20.00 if needed to determine quality of oil. L Oily Waste Water $0.80/gallon Oxidizer gallon $9.80 $1.30/ pound 5 gallon $52.00 55 gallon $311.85 Paint (Latex & Oil Based) quart no fee* $0.25/ pound or $15 minimum handling fee gallon no fee* 5 gallon no fee* PCB Ballast (and non PCB) $0.75/ pound Peroxide Formers gallon $30.50 .. ... ... 5 gallon $162.50 55 gallon $974.90 gallon $9.80 Liquid Pesticide/Poison Li d 5 gallon $52.00 55 gallon $311.85 55gallon bulk $498.50 Pesticide, dry � �� " �� $1.05/ pound Water Reactive, Shock Sensitive quart $12.05 $3.10/ pound if < quart gallon $48.20 5 gallon $241.00 Miscellaneous Items To be determined, subject to ma ket rate. Minimum Fee $15 *Latex and oil based paint are not charged due to contract with PaintCare. WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE 2018 Proposed HOUSEHOLD CODE SIZE 2017 2018 Code Code Code Code Code CURRENT PROPOSED Code Procedure 1 2 3 4 5 3.0°fo'' Yellow - New Procedures/Codes 99201 Minimal* 0.00 12.50 25.00 37.50 50.00 49.00 50.00 99202 Expanded* 0.00 29.25 58.50 87.75 117.00 114.00 117.00 99203 Detailed* 0.00 38.00 76.00 114.00 152.00 148.00 152.00 99204 Comprehensive* 0.00 56.75 113.50 170.25 227.00 220.00 227.00 Established Client 99211 Minimal* 0.00 11.25 22.50 33.75 45.00 44.00 45.00 99212 Focused* 0.00 19.00 38.00 57.00 76.00 74.00 76.00 99213 Expanded* 0.00 24.75 49.50 74.25 99.00 96.00 99.00 99214 Detailed* 0.00 39.00 78.00 117.00 156.00 151.00 156.00 Home Visits 99341 New Client - Focused 92.00 92.00 92.00 92.00 92.00 89.00 92.00 99342 New Client - Expanded 92.00 92.00 92.00 92.00 92.00 89.00 92.00 99347 Est. Client - Focused 92.00 92.00 92.00 92.00 92.00 89.00 92.00 99348 Est. Client - Expanded 92.00 92.00 92.00 92.00 96.00 93.00 96.00 Preventive Medicine Counseling (Family Planning) 99401 Individual - 15 min* 0.00 12.00 24.00 36.00 48.00 47.00 48.00 99402 Individual - 30 min* 0.00 17.25 34.50 51.75 69.00 67.00 69.00 99403 Individual - 45 min* 0.00 24.00 48.00 72.00 96.00 93.00 96.00 Travel Visits 99404 Individual Initial Visit - 60 124.00 124.00 124.00 124.00 124.00 120.00 124.00 99401W Return Visit 57.00 57.00 57.00 57.00 57.00 55.00 57.00 99412 Group Initial Visit (per person) - 60 57.00 57.00 57.00 57.00 57.00 55.00 57.0O Preventive Medicine 99384 New Client 12-17 years old* 0.00 38.00 76.00 114.00 152.00 148.00 152.00 99385 New Client 18-39 years old* 0.00 38.00 76.00 114.00 152.00 148.00 152.00 99386 New Client 40-64 years old* 0.00 41.25 82.50 123.75 165.00 160.00 165.00 99394 I Est. Client 12-17 years old* 0.00 32.00 64.00 96.00 128.00 124.00 128.00 99395 Est. Client 18-39 years old* 0.00 32.75 65.50 98.25 131.00 127.00 131.00 99396 Est. Client 40-64 years old* 0.00 34.75 69.50 104.25 139.00 135.00 139.00 Additional Codes 0071W Community Education 1 hr. 74.00 74.00 74.00 74.00 74.00 72.00 74.00 0069W Travax Printout 15.00 15.00 15.00 15.00 15.00 15.00 15.00 G9006 NHV Mother - Task Care Management 15.00 15.00 15.00 15.00 15.00 15.00 15.00 T1017 NHV Child - Task Care Management 15.00 15.00 15.00 15.00 15.00 15.00 15.00 STI Exam pre -pay -NP 15.00 15.00 15.00 15.00 193.00 187.00 193.00 Wellness Package 15.00 15.00 15.00 15.00 49.00 48.00 49.00 99499 TB Consultation 193.00 193.00 193.00 193.00 45.00 44.00 45.00 PROCEDURES 56420 Bartholin Cyst 0.00 0.00 0.00 0.00 140.00 136.00 140.00 11100 Biopsy of skin, single 0.00 0.00 0.00 0.00 118.00 115.00 118.00 57500 Cervical Lesion Biopsy 147.00 147.00 147.00 147.00 147.00 143.00 147.00 0116W Chest X -Ray (Prepay) 67.00 67.00 67.00 67.00 67.00 65.00 67.00 57452 Colposcopy without Biopsy** _ 126.00 126.00 126.00 126.00 126.00 122.00 126.00 57454 Colposcopy with Biopsy** 176.00 176.00 176.00 176.00 176.00 171.00 176.00 57511 Cryocautery cervix- initial or repeat 167.00 167.00 167.00 167.00 167.0O 162.00 167.00 17000 I Cryotherapy first lesion** 77.00 77.00 77.00 77.00 77.00 I 75.00 77.00 17003 Cryotherapy 2-14 lesions** 7.00 7.00 7.00 7.00 7.00 6.00 7.00 17004 Cryotherapy 15 + lesions** 173.00 173.00 173.00 173.00 173.00 168.00 173.00 56501 Destruction Lesion Vulva 150.00 150.00 150.00 150.00 150.00 146.00 150.00 57170 Diaphragm/Cervical Cap Fitting* 0.00 23.75 47.50 71.25 95.00 92.00 95.00 58100 Endometrial biopsy w/wo Biopsy 126.00 126.00 126.00 126.00 126.00 122.00 126.00 58110 Endometrial biopsy with Colposcopy 68.00 68.00 68.00 68.00 68.00 66.00 68.00 Essure by referral*** 0.00 0.00 0.00 0.00 0.00 0.00 0.00 11400 Excisions, benign lesion 142.00 142.00 142.00 142.00 142.00 138.00 142.00 11981 Implanon Insertion* 0.00 49.00 98.00 147.00 196.00 190.00 196.00 10060 incision & arainage or access, single or simple 135.00 135.00 135.00 135.00 135.00 131.00 135.00 58300 Insertion IUD* 0.00 49.25 98.50 147.75 197.00 191.00 197.00 57460 LEEP with biopsy 324.00 324.00 324.00 324.00 324.00 315.00 324.00 57461 LEEP with conization 368.00 368.00 368.00 368.00 368.00 357.00 368.00 88305 Level 4 - Surgical pathology 1st site 108.00 108.00 108.00 108.00 108.00 105.00 108.00 88305W Level 4 - Surgical Pathology 2nd site & eacl 108.00 108.00 108.00 108.00 108.00 105.00 108.00 59025 Non Stress Test Interp 0.00 0.00 0.00 0.00 0.00 0.00 0.00 11976 Removal, implant contraceptive (Implanon)i 0.00 58.25 116.50 174.75 233.00 226.00 233.00 11983 Removal implant, with reinsertion* 0.00 89.25 178.50 267.75 357.00 347.00 357.00 58301 Removal IUD* 0.00 39.50 79.00 118.50 158.00 153.00 158.00 A4550 Surgical Tray 71.00 71.00 71.00 71.00 71.00 69.00 71.00 11300 Shaving of epidermal lesion, single on trunk, arms or legs, .5cm 111.00 111.00 111.00 111.00 111.00 108.00 111.00 76857 Ultrasound - pelvic non -obstetric 76.00 76.00 76.00 76.00 76.00 74.00 76.00 FAMILY PLANNING SUPPLIES A4267 Condoms pkg 10* 0.00 1.75 3.50 5.25 7.00 7.00 7.00 0052W Cycle Beads* 0.00 3.75 _ 7.50 11.25 15.00 15.00 15.00 A4266 Diaphragm* 0.00 8.25 16.50 24.75 33.00 32.00 33.00 A4269 Foam Contraception* 0.00 3.00 6.00 9.00 12.00 12.00 12.00 J7307 Nexplanon (Etonogestrel)* 0.00 210.50 421.00 631.50 842.00 817.00 842.00 J7306 Levonorgestrel 0.00 210.50 421.00 631.50 842.00 I 817.00 842.00 J7298 IUD Mirena* 0.00 241.50 483.00 '724.50 966.00 938.00 966.00 J7300 I IUD Paragard* 0.00 200.75 401.50 ,602.25 803.00 780.00 803.00 J7301 IUD Skyla* 0.00 224.00 448.00 672.00 896.00 870.00 896.00! Revised 11/09/2017 Page 1 of 4 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE Code Code Code Code Code CURRENT PROPOSED Code Procedure 1 2 3 4 5 ,` , o Yellow - New Procedures/Codes J7297 IUD Liletta 0.00 164.25 328.50 492.75 657.00 264.00 657.00 Q9984 IUD Kyleena 0.00 143.75 287.50 431.25 575.00 0.00 575.00 J1050 Medroxyprogesterone 150mg IM (Depo)* 0.00 18.25 36.50 54.75 73.00 71.00 73.00 96372 Admin fee depo- if visit for injection only 0.00 7.25 14.50 21.75 29.00 28.00 29.00 J7303 Nuva Ring* 0.00 10.75 21.50 32.25 43.00 42.00 43.00 S4993 Oral Contraceptives* 0.00 7.75 15.50 23.25 31.00 30.00 31.00 0068W Seasonale* 0.00 18.25 36.50 54.75 73.00 71.00 73.00 0065W Today's Sponge* 0.00 1.25 2.50 3.00 5.00 5.00 5.00 LAB 86900 ABO blood typing 0.00 1.25 2.50 3.75 5.00 5.00 5.00 82947 Assay, body fluid, glucose, (FBS)* 0.00 5.50 11.00 16.50 22.00 21.00 22.00 85025 CBC w/Diff 23.00 23.00 23.00 23.00 23.00 22.00 23.00 85027 CBC w/o Diff 20.00 20.00 20.00 20.00 20.00 19.00 20.00 87491 Chlamydia PCR* 0.00 12.50 25.00 37.50 50.00 49.00 50.00 87491 NS Chlamydia PCR* - full fee 50.00 50.00 50.00 50.00 50.00 49.00 50.00 80053 Comprehensive Metabolic Panel 14.00 14.00 14.00 14.00 14.00 14.00 14.00 0090W Court Ordered Lab Draw 16.00 16.00 16.00 16.00 16.00 16.00 16.00 82627 DHEAS 31.00 31.00 31.00 31.00 31.00 30.00 31.00 83001 FSH 38.00 38.00 38.00 38.00 38.00 37.00 38.00 87591 Gonorrhea PCR* 0.00 12.00 24.00 36.00 50.00 49.00 50.00 87591 NS Gonorrhea PCR* - full fee 50.00 50.00 50.00 50.00 50.00 49.00 50.00 82948 Glucose Random 8.00 8.00 8.00 8.00 8.00 8.00 8.00 82951 Glucose Tolerance Test 2 hr (GTT) 27.00 27.00 27.00 27.00 27.00 26.00 27.00 87205 Gram Stain 29.00 29.00 29.00 29.00 29.00 28.00 29.00 84702 HCG Quantitative - Serum Pregnancy Test 44.00 44.00 44.00 44.00 44.00 43.00 44.00 84703 HCG Qualitative - Serum Pregnancy Test 44.00 44.00 44.00 44.00 44.00 43.00 44.00 83718 HDL Cholesterol 33.00 33.00 33.00 33.00 33.00 32.00 33.00 86706 Hep B Surface Antibody 26.00 26.00 26.00 26.00 26.00 25.00 26.00 87255 Herpes Culture 76.00 76.00 76.00 76.00 76.00 74.00 76.00 86695 Herpes Select - Type I (89999A33) 76.00 76.00 76.00 76.00 76.00 74.00 76.00 86696 Herpes Select - Type II (89999A33) 76.00 76.00 76.00 76.00 76.00 74.00 76.00 85018 HGB - (Finger Stick)* 0.00 3.50 7.00 10.50 14.00 14.00 14.00 83036 HGBA1c 36.00 36.00 36.00 36.00 36.00 35.00 36.00 86701 HIV 1/2 AB Diff (this is HIV 1) 12.00 12.00 12.00 12.00 12.00 12.00 12.00 86702 HIV 1/2 AB Diff (this is HIV 2) 13.00 13.00 13.00 13.00 13.00 13.00 13.00 86703 HIV Screen, ELISA 26.00 26.00 26.00 26.00 26.00 25.00 26.00 87389 HIV - 1 antigen w/ HIV -1 & HIV -2 26.00 26.00 26.00 26.00 26.00 25.00 26.00 G0435 HIV Screen, Rapid Test I 26.00 26.00 26.00 26.00 26.00 25.00 26.00 87624 HPV, High Risk 76.00 76.00 76.00 76.00 76.00 74.00 76.00 87625 HPV typing 16,18,45 47.00 47.00 47.00 47.00 47.00 46.00 47.00 0081W HPV, High Risk w/ repeat pap (LabCorp us(l 121.00 121.00 121.00 121.00 121.00 117.00 121.00 484006W Immunohistochemical Stain 109.00 109.00 109.00 109.00 109.00 106.00 109.00 87254 Influenza - Viral Culture 46.00 46.00 46.00 46.00 46.00 45.00 46.00 83525 Insulin, Fasting 15.00 15.00 15.00 15.00 15.00 15.00 15.00 83002 LH 38.00 38.00 38.00 38.00 38.00 37.00 38.00 80061W Lipid Panel - SFS* 0.00 10.00 20.00 30.00 40.00 39.00 40.00 80061N Lipid Panel 40.00 40.00 40.00 40.00 40.00 39.00 40.00 80076 Liver Panel 32.00 32.00 32.00 32.00 32.00 31.00 32.00 86790 MAC Elisa 132.00 132.00 132.00 132.00 132.00 128.00 132.00 80048 Metabolic Panel 33.00 33.00 I 33.00 I 33.00 33.00 32.00 33.00 86376 Microsomal antibodies 18.00 18.00 18.00 18.00 18.00 0.00 18.00 82274 Occult Blood Test, Fecal, IA* 1 31.00 31.001 31.00 31.00 31.00 30.00 31.00 88142 Pap - Thin Prep* 0.00 11.50 23.00 34.50 46.00 45.00 46.00 0080W Pap, repeat thin prep 46.00 46.00 46.00 46.00 46.00 45.00 46.00 88175 Pap, Thin prep, w HR HPV, Reflex 16,18.4E 123.00 123.00 123.00 123.00 123.00 119.00 123.00 88141 Physician Read Pap 37.00 37.00 37.00 37.00 37.00 36.00 37.00 84146 Prolactin 40.00 40.00 40.00 40.00 40.00 39.00 40.00 86901 RH blood type 0.00 1.75_ 3.50 5.25 7.00 7.00 7.00 87535 RNA Qaul. 47.00 47.00 47.00 47.00 47.00 46.00 47.00 86592 RPR/Syphillis test 25.00 25.00 25.00 25.00 25.00 24.00 25.00 87798 RT-PCR comprehensive- serum and urine 686.00 686.00 686.00 686.00 686.00 666.00 686.00 87081 Streptococcus - Hemolytic 9.00 9.00 9.00 9.00 9.00 8.00 9.00 84480 T3 Triiodothyronine 49.00 49.00 49.00 49.00 49.00 48.00 49.00 84481 TT -3 (Free -Unbound) 49.00 49.00 49.00 49.00 49.00 48.00 49.00 84436 T4 Thyroxine 9.00 9.00 9.00 9.00 9.00 9.00 9.00 84439 T4 (Total Free -Unbound) 11.00 11.00 11.00 11.00 11.00 11.00 11.00 84403 Testosterone, Total 36.00 36.00_ 36.00 36.00 36.00 35.00 36.00 82465 Total Cholesterol 24.00 24.00 24.00 24.00 24.00 23.00 24.00 87661 Trichomonas vaginalis - amplified 46.00 46.00 46.00 46.00 46.00 45.00 46.00 84443 TSH 36.00 36.00 36.001 36.00 36.00 35.00 36.00 86480 Tuberculosis Test-Quantiferon (IGRA) 96.00 96.00 96.00 96.00 96.00 93.00 96.00 81001 Urinalysis, complete with micro ex 7.00 7.00 7.00 7.00 7.00 7.00 7.00 81002 Urinalysis, w/o scope (UA) 10.00 10.00 10.00 10.00 10.00 10.00 10.00 87086 Urine Culture, Comprehensive 11.00 11.00 11.00 11.00 11.00 11.00 11.00 81025 Urine Preganancy Test* 0.00 3.75 7.50 11.25 15.00 15.00 15.00 36415 Venipuncture 6.00 6.00 6.00 6.00 6.00 6.00 6.00 36415W Venipuncture with sliding fee lab 0.00 1.50 3.00 4.50 6.00 6.00 6.00 36416 Venipuncture - capillary blood specimen 6.00 6.00 6.00 6.00 6.00 6.00 6.00 36416W Venipuncture - capillary blood specimen 0.00 1.50 3.00 4.50 6.00 6.00 6.00 96372 Admin fee for Depo and antibiotics 0.00 7.25 14.50 21.75 29.00 28.00 29.00 87210 Wet Prep 26.00 26.00 26.00 26.00 26.00 25.00 26.00 MEDICINES and TREATMENTS 0020W Amoxicillin 875 mg #20 16.00 16.00 16.00 16.00 16.00 16.00 16.00 0062W Azythromycin, Z pack 16.00 16.00 16.00 16.00 16.00 16.00 16.00 101456W Azithromycin 1g - partner pack 11.00 11.00 11.00 11.00 11.00 11.00 11.00 0456W Azithromycin State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 J0696 Ceftriaxone 250 mg 34.00 0.00 33.00 34.00 34.00 33.00 34.00 0696W Ceftriaxone 250 mg State Supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Revised 11/09/2017 Page 2 of 4 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE Code Code Code Code Code CURRENT] PROPOSED Code Procedure 1 2 3 4 5 J Yellow - New Procedures/Codes 0007W Cephalexin 500 mg #14 10.00 10.00 10.00 10.00 10.00 10.00 10.00 0058W Ciprofloxcin 500 mg #6 16.00 16.00 16.00 16.00 16.00 16.00 16.00 0035W Condylox 10.00 10.00 10.00 10.00 10.00 10.00 10.00 0005W Doxycycline 100 mg #14 11.00 11.00 11.00 11.00 11.001 11.00 11.001 0059W _ Estradiol 1 mg- #100 16.00 16.00 16.00 16.00 1 16.00 16.00 16.00 0011W Fluconazole 150 mg #1 23.00 23.00 23.00 23.00 23.00 22.00 23.001 0012W Limn 12.00 12.00 12.00 1 12.00 12.00 12.00 12.00 J0561 LA Bicillin 2.4 Units 5.00 5.00 5.00 5.00 5.00 0.00 5.001 0060W Medroxyprogesterone 10 mg - #5 16.00 16.00 16.001 16.00 16.00 16.00 16.00 0008W Metrogel 10.00 10.00 10.00 10.00 10.00 10.00 10.00 0009W Metronidazole 500 mg #4 10.00 10.00 10.00 10.00 10.00 10.00 10.00 0010W Metronidazole 500 mg #14 15.00 15.00 15.00 15.00 15.00 15.00 15.00 0013W Metronidazole 250 mg #28 15.00 15.00 15.00 15.00 15.00 15.00 15.00 0006W Misoprostel (Cytotec) 200 mcg #2 10.00 10.00 10.00 10.00 10.00 10.00 10.00 0016W Podophyllin/TCA 16.00 16.00 16.001 16.00 16.00 16.00 16.00 0004W Sulfatrim SMX/TMP 10.00 10.00 10.00 10.00 10.00 10.00 10.00 00180W Suprax 400 mg #1 - partner pak 29.00 29.00 29.001 29.00 29.00 28.00 29.001 00180NC Suprax 400 mg #1 - State Supplied 0.00 0.00 0.001 0.00 0.001 1 0.00 0.00 IMMUNIZATIONS 90471 Imm. Admin - one vaccine 29.00 29.00 29.00 29.00 29.00 28.00 29.00 90472 Imm Admin - each addl. Vaccine 29.00 29.00 29.00 29.00 29.00 28.00 29.001 90473 Imm Admin - intranasal or oral 29.00 29.00 29.00 29.00 29.00 28.00 29.00 90700N DTaP -State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90700 DTaP 32.00 32.00 32.00 32.00 32.00 31.00 32.00 90702N DT - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90633N Hepatitis A - Child - State supplied 0.00 0.00 0.00 0.00 0.00 1 0.00 0.00 90633 Hepatitis A - Child 34.00 34.00 34.00 34.00 34.00 33.00 34.00 90632N Hepatitis A - Adult - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90632 Hepatitis A - Adult 90.00 90.00 90.00 90.00 90.00 87.00 90.00 90744N Hepatitis B - Child - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90744 Hepatitis B - Child 29.00 29.00 29.00 29.00 29.00 28.00 29.00 90746N Hepatitis B - Adult - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90746 Hepatitis B - Adult 83.00 83.00 83.00 83.00 83.00 81.00 83.00 90647N HIB - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90647 HIB 38.00 38.00 38.00 38.00 38.00 37.00 38.00 90651N HPV 9 - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90651 HPV 9 184.00 184.00 184.00 184.00 184.00 179.00 184.00 90281 IG Hepatitis A - State supplied _ 0.00 0.00 0.00 0.00 0.001 0.00 0.00 90660N Influenza - intranasal use - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90660 Influenza - Intranasal Adult 36.00 36.00 36.00 36.00 36.00 35.00 36.00 90687 Influenza - infant quadrivalent 36.00 36.00 36.00 36.00 36.00 35.00 36.00 90687N Influenza - infant quadrivalent - State suppli 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90688 Influenza - 3 yrs and up - quadrivalent 36.00 36.00 36.00 36.00 36.00 35.00 36.00 90688N Influenza - 3 yrs and up - State supplied qua 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90713N IPV-VFC - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90713 IPV 70.00 70.00 70.00 70.00 70.00 68.00 70.00 90738 Japanese Encephalitis (new formulation) 318.00 318.00 318.00 318.00 318.00 309.00 318.00 90696N Kinrix - (DTaP/IPV)/Quadracel - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90696 Kinrix - (DTaP/IPV)/Quadracel 62.00 62.00 62.00 62.00 62.00 60.00 62.00 90734N MCV4 - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90734 MCV4 169.00 169.001 169.00 169.00 169.001 164.00 169.00 90620 MenB 161.00 161.00 161.00 161.00 161.00 0.00 161.00 90733 MPSV4 (Menomune)(polysaccharide) 169.00 169.00 169.00 169.00 169.00 164.00 169.00 90707N 1 MMR - State supplied 0.00 0.00 0.001 0.00 0.00 I 0.00 0.00 90707 MMR 71.00 71.00 71.00 71.00 71.00 69.00 71.00 90723N Pediarix (DTAP, IPV, Hep B) - State supplic 0.00 0.00 0.001 0.00 0.001 1 0.001 0.00 90723 Pediarix - (DTaP/IPV/Hep B) 87.00 87.00 87.00 87.00 87.00 84.00 87.00 90698N Pentacel - (DTaP/IPV/HepB) - State supplie 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90698 Pentacel - (DTaP/IPV/HepB) 128.00 128.00 128.00 128.00 128.00 124.00 128.00 90732N Pneumovax - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90732 Pneumovax 87.00 87.00 87.00 87.00 87.00 84.00 87.00 90710N Proquad - MMR-Varicella 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90710 Proquad - MMR-Varicella 197.00 197.00 197.00 197.00 197.00 191.00 197.00 90670N Prevnar - (PCV13) - State supplied 1 0.001 0.001 0.00 0.001 0.00 0.00 0.00 90670 Prevnar - (PCV13) 188.00 188.00 188.00 188.00 188.00 183.00 188.00 90675 Rabies IM 270.00 270.00 270.00 270.00 270.00 262.00 270.00 90675N Rabies IM - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90375 RIG (rabies) - per cc 241.00 241.00 241.00 241.00 241.00 234.00 241.00 90680N Rotavirus - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90680 Rotavirus - (RV5) 97.00 97.00 97.00 97.00 97.00 94.001 97.00 90714N Td - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90714 Td - 57.00 57.00 57.00 57.00 57.00 55.00 57.00 90715N Tdap - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90715 Tdap - 111.00 111.00 111.00 111.00 111.00 108.00 111.00 86580 Tuberculosis Interdermal Skin Test (PPD) 49.00 49.00 49.00 49.00 49.00 48.00 49.00 90636 Twinrix - Hep A & HepB 1 122.00 122.00 122.00 122.00 122.00 118.00 122.00 90691 Typhoid - 1 Shot 79.00 79.00 79.00 79.00 79.00 77.00 79.00 90690 Typhoid - Oral 69.00 69.00 69.00 69.00 69.001 67.00 69.001 90716N Varivax - State supplied 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90716 Varivax 122.00 122.00 122.00 122.00 122.00 118.00 122.00 90717 Yellow Fever 156.00 156.00 156.00 156.00 156.00 151.00 156.00 1 Miscellaneous INC Service Includes Follow-up Care I 0.00 0.00 0.00 0.00 0.00 0.00 0.00 99212 Antepartum Care 1 visit 76.00 76.00 76.00 76.00 76.00 74.00 76.00 59425 Antepartum care 4-6 visits 677.00 677.00 677.00 677.00 677.00 657.00 677.00 59426 Antepartum care 7 or more visits 1391.00 1391.00 1391.00 1391.00 1391.00 1350.00 1391.00 99402W PE Establishing Medical Record 66.00 66.00 66.00 66.00 66.00 64.00 66.00 0255W Phone visit 0.00 0.00 0.001 0.00 0.00 0.00 0.001 Revised 11/09/2017 Page 3 of 4 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH ENVIRONMENT PUBLIC HEALTH SERVICES - 2018 SLIDING FEE SCHEDULE Code Code Code Code Code CURRENT PROPOSED Code Procedure 1 2 3 4 5 3.0%. Yellow - New Procedures/Codes 59430 Post Partum Only 216.00 216.00 216.00 216.00 216.00 210.00 216.00 H1005 Prenatal Plus (1-4 visits) 197.00 197.00 197.00 197.00 197.00 191.00 197.00 H1005 Prenatal Plus (5-9 visits) 523.00 523.00 523.00 523.00 I 523.00! 508.00 523.00 H1005 Prenatal Plus (10 visits) 983.00 983.00 983.00 983.00 983.00 954.00 983.00 H1005 Prenatal Plus (11 or more visits) 1113.00 1113.00 1113.00 1113.00 1113.00 1081.00 1113.00 * Fees only slide for the Family Planning Program. Charges for all other programs are the Code 5 fee. ** Services include surgical procedure only. *** These items are for referral 11/8/2017 revised Revised 11/09/2017 Page 4 of 4 Hello