RATE METHODOLOGY INPUTS BY CODE - …...• Sphygmomanometer • Exam Lights • Otoscope • Reflex...
Transcript of RATE METHODOLOGY INPUTS BY CODE - …...• Sphygmomanometer • Exam Lights • Otoscope • Reflex...
Rate Methodology Inputs by Code HCPCs 2018 P a g e | 1
RATE METHODOLOGY INPUTS BY CODE
Methodology In the development of rates for new procedure codes resulting from annual HCPCS updated, the
Department began using the following rate methodology, for rates effective January 1, 2018. The
Department’s rate methodology incorporates four factors: indirect and direct care salary
expenses, facility expenses, administrative expenses, and capital expenses, for all services
required as part of each fee-for-service rate. Each factor is detailed below.
All Facility, Administrative, and Capital-Overhead expenses are reduced to per employee cost and
multiplied by the total FTE required to provide services per Medicaid client.
Please note, Dental, Physician Administered Drugs, and Durable Medical Equipment codes are
setting using a different methodology and are not include in the list below.
For details on the methodology for procedure codes that can be billed with a TC modifier and 26
modifier please see the HCPCS 2018 rate methodology document.
Indirect and Direct Care Salary expectations for direct and indirect care workers based on the Colorado mean wage for
each position, direct and indirect care hours for each position, the full-time equivalency
required for the delivery of services to Medicaid clients. Wages are determined by the
Bureau of Labor Statistics (BLS) and are updated by the Bureau every two years. Direct and
indirect care hours required and the full-time equivalent of each position are based on
procedure description from the AMA CPT® Professional Edition.
Facility Expense Expectations This factor incorporates the facility type using property records listing square footage and
actual value. Facility expenses also include estimated repair and maintenance expenses,
utility expenses, and phone and internet expenses. Repair and maintenance price per square
foot is determined using industry standards and varies for facilities that are leased and
facilities that are owned. Utility pricing includes gas and electricity which are determined
annually through the Public Utility Commission which provides summer and winter rates as
well as thermal conversions for appropriated pricing. Internet and phone services are
determined using the Comcast Business Class website estimates. Finally, miscellaneous
expenses are determined to capture additional inputs, such special events that are necessary
but not easily categorized and do not occur in specific frequencies or time intervals.
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Administrative Expectations Identifies computer, software, office supply costs, and the total number of employees to
determine administrative and operating costs per employee.
Capital Expectation This expense incorporates capital expenses, outside of the facility, that are directly related
to providing the services to Medicaid clients. Capital Overhead Expenses are prorated over
the estimated life of the equipment or estimated warranty of the equipment.
Feedback received • Radiology providers contacted the department about our radiology rates with the
TC and 26 modifiers. Based on this feedback, an adjustment was made to the
inputs included in the TC and 26 modifier rates.
Inputs by Code for Stakeholder Feedback When providing feedback, please provide metrics and/or relevant documentation to
substantiate feedback. Please note that Dental Codes, Durable Medical Equipment, and
Physician Administered Drug Codes are not included in this document as that have a specific
methodology.
The tables below detail the following information for each code:
• Proc Code is the is the CPT or HCPCs code for each specific procedure
• BLS Position(s) is the title and position number from the Bureau of Labor Statistics
website.
• BLS Wage is the Colorado wage associated to the applicable BLS position (Not
Including Taxes and Benefits).
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
15730
Oral and Maxillofacial
Surgeons 29-1022 $132.09 2.75 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
Oral and Maxillofacial
Surgeons 29-1022 $132.09 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
3
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
15733
Oral and Maxillofacial
Surgeons 29-1022 $132.09 3.25 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
Oral and Maxillofacial
Surgeons 29-1022 $132.09 0.75 0.17
Registered Nurses 29-1141
$33.92 0.75 0.17
19294 Registered Nurses
29-1141 $33.92 2.00 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
20939 Physicians and
Surgeons, All Other 29-1069
$115.17 0.17 0.05
• Electrocephalogram
• Reflex Hammer
• Exam Chair
• Exam Table
31241 Physicians and
Surgeons, All Other 29-1069
$115.17 1.89 0.17
• Compound Microscope
• Nasal Endoscope
• Medical Lights
• Exam Chair
• Exam Table
• Nasal Endoscope Light Source/ Monitor System
31253 Physicians and
Surgeons, All Other 29-1069
$115.17 2.03 0.17
• Compound Microscope
• Nasal Endoscope
• Medical Lights
• Exam Chair
• Exam Table
• Nasal Endoscope Light Source/ Monitor System
4
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
31257 Physicians and
Surgeons, All Other 29-1069
$115.17 1.78 0.17
• Compound Microscope
• Nasal Endoscope
• Medical Lights
• Exam Chair
• Exam Table
• Nasal Endoscope Light Source/ Monitor System
31259 Physicians and
Surgeons, All Other 29-1069
$115.17 1.90 0.17
• Compound Microscope
• Nasal Endoscope
• Medical Lights
• Exam Chair
• Exam Table
• Nasal Endoscope Light Source/ Monitor System
31298 Physicians and
Surgeons, All Other 29-1069
$115.17 1.22 0.17
• Compound Microscope
• Nasal Endoscope
• Medical Lights
• Exam Chair
• Exam Table
• Nasal Endoscope Light Source/ Monitor System
32994
Surgeons 29-1067 $125.63 1.22 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Cardiovascular Technologists and Technicians 29-
2031
$32.94 0.00 0.50
5
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
33927
Surgeons 29-1067 $125.63 7.00 1.00
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
•
Registered Nurses 29-1141
$33.92 0.00 1.00
Surgeons 29-1067 $125.63 4.50 0.45
Registered Nurses 29-1141
$33.92 5.25 0.45
33928
Surgeons 29-1067 $125.63 6.00 1.00
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
•
Registered Nurses 29-1141
$33.92 0.00 1.00
Surgeons 29-1067 $125.63 4.50 0.45
Registered Nurses 29-1141
$33.92 5.25 0.45
33929
Surgeons 29-1067 $125.63 3.00 0.50
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
•
Registered Nurses 29-1141
$33.92 0.00 0.50
6
Proc Code BLS Position(s)
BLS Wage(s) (Not
Including Taxes and Benefits)
Expected Direct
Care Hours per
procedure
Expected Indirect Care
Hours per procedure • Capital Included
34701
Surgeons 29-1067 $125.63 3.17 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
34702
Surgeons 29-1067 $125.63 4.55 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 1.00 0.17
Registered Nurses 29-1141
$33.92 1.00 0.17
34703
Surgeons 29-1067 $125.63 3.51 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
34704
Surgeons 29-1067 $125.63 4.88 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 1.00 0.17
Registered Nurses 29-1141
$33.92 1.00 0.17
7
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure • Capital Included
34705
Surgeons 29-1067 $125.63 4.17 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
34706
Surgeons 29-1067 $125.63 5.21 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 1.00 0.17
Registered Nurses 29-1141
$33.92 1.00 0.17
34707
Surgeons 29-1067 $125.63 3.23 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
34708
Surgeons 29-1067 $125.63 5.21 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 1.00 0.17
Registered Nurses 29-1141
$33.92 1.00 0.17
8
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
34709 Surgeons 29-1067 $125.63 0.83 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
34710
Surgeons 29-1067 $125.63 2.00 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
34711 Surgeons 29-1067 $125.63 0.83 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
34712
Surgeons 29-1067 $125.63 2.50 0.17 • Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
Surgeons 29-1067 $125.63 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
9
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
34713 Surgeons 29-1067 $125.63 0.17 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
34714 Surgeons 29-1067 $125.63 0.42 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
34715 Surgeons 29-1067 $125.63 0.67 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
34716 Surgeons 29-1067 $125.63 0.83 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
10
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
36465
Physicians and Surgeons, All Other 29-1069
$115.17 0.25 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Registered Nurses 29-1141
$33.92 0.00 0.17
36466
Physicians and Surgeons, All Other 29-1069
$115.17 0.25 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Registered Nurses 29-1141
$33.92 0.00 0.17
36482
Physicians and Surgeons, All Other 29-1069
$115.17 0.33 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Registered Nurses 29-1141
$33.92 0.00 0.17
36483
Physicians and Surgeons, All Other 29-1069
$115.17 0.33 0.17
• EKG Machine
• Stress Testing Machine System Cost
• Holter Monitors
• Vascular Ultrasound Machine
• Sphygmomanometer
• Stethoscope
• Pulse Oximeter
• Exam Chair
• Exam Table
Registered Nurses 29-1141
$33.92 0.00 0.17
11
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
38222
Physicians and Surgeons, All Other 29-1069
$115.17 0.50 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Hemotology Analyzer
• Flow Cytometer
• Coagulation Analyzer
• Slide Stainer
Registered Nurses 29-1141
$33.92 0.00 0.17
38573
Surgeons 29-1067 $125.63 2.90 0.17 • Compound Microscope
• Endoscopic Video System
• Medical Lights
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
43286
Surgeons 29-1067 $125.63 5.00 0.17 • Compound Microscope
• Endoscopic Video System
• Medical Lights
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 1.00 0.17
Registered Nurses 29-1141
$33.92 1.00 0.17
43287
Surgeons 29-1067 $125.63 5.21 0.17 • Compound Microscope
• Endoscopic Video System
• Medical Lights
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 1.00 0.17
Registered Nurses 29-1141
$33.92 1.00 0.17
43288
Surgeons 29-1067 $125.63 5.66 0.17 • Compound Microscope
• Endoscopic Video System
• Medical Lights
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 1.00 0.17
Registered Nurses 29-1141
$33.92 1.00 0.17
12
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
55874 Physicians and Surgeons, All Other 29-1069
$115.17 0.50 0.17
• Compound Microscope
• Endoscopic Video System
• Medical Lights
• Exam Chair
• Exam Table
58575
Surgeons 29-1067 $125.63 2.17 0.17 • OB/GYN Table
• Stool
• Instrument Stand
• Ultrasound Machine
• Endoscope Video System
• Endoscope Light Source
• Colposcope
Surgeons 29-1067 $125.63 0.50 0.17
Registered Nurses 29-1141
$33.92 0.50 0.17
64912
Surgeons 29-1067 $125.63 2.50 0.17
• Electrocephalogram
• Reflex Hammer
• Exam Chair
• Exam Table
Surgeons 29-1067 $125.63 0.75 0.17
Registered Nurses 29-1141
$33.92 0.75 0.17
64913 Surgeons 29-1067 $115.17 0.42 0.17
• Compound Microscope
• Endoscopic Video System
• Medical Lights
• Exam Chair
• Exam Table
71045
Physicians and Surgeons, All Other 29-1069
$115.17 0.04 0.03 • Radiologist Computer Monitors
• Desk
• Chair
• X-Ray Machine
Radiologic Technologists 29-
2034 $30.60 0.03 0.03
13
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
71046
Physicians and Surgeons, All Other 29-1069
$115.17 0.08 0.03 • Radiologist Computer Monitors
• Desk
• Chair
• X-Ray Machine
Radiologic Technologists 29-
2034 $30.60 0.07 0.03
71047
Physicians and Surgeons, All Other 29-1069
$115.17 0.11 0.03 • Radiologist Computer Monitors
• Desk
• Chair
• X-Ray Machine
Radiologic Technologists 29-
2034 $30.60 0.10 0.03
71048
Physicians and Surgeons, All Other 29-1069
$115.17 0.15 0.03 • Radiologist Computer Monitors
• Desk
• Chair
• X-Ray Machine
Radiologic Technologists 29-
2034 $30.60 0.13 0.03
74018
Physicians and Surgeons, All Other 29-1069
$115.17 0.04 0.03 • Radiologist
Computer Monitors
• Desk
• Chair
• X-Ray Machine
Radiologic Technologists 29-
2034
$30.60 0.03 0.03
74019
Physicians and Surgeons, All Other 29-1069
$115.17 0.08 0.03 • Radiologist Computer Monitors
• Desk
• Chair
• X-Ray Machine
Radiologic Technologists 29-
2034 $30.60 0.07 0.03
14
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
74021
Physicians and Surgeons, All Other 29-1069
$115.17 0.12 0.03 • Radiologist Computer Monitors
• Desk
• Chair
• X-Ray Machine
Radiologic Technologists 29-
2034 $30.60 0.10 0.03
81105-81112
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Other Lab Equipment
• DNA Sequencer
• DNA Recovery- Blood Sample
• Reagent Kit
• Inherited Disease Sequencing Panel
81120
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Gene Analyzer
• Other Equipment
• DNA Recovery Kit for FFPE
• Isocitrate Dehydrodrogenase 1 Soluble Kit
15
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
81121
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Gene Analyzer
• Other Equipment)
• DNA Recovery Kit for FFPE
• Isocitrate Dehyrogenase Kit
81175
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• DNA Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit
• Gene Panel
• AmpliSeq Gene Library
16
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
81176
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• DNA Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit
• GenePanel
• Gene Library
• Index Adaptor
81238
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• DNA Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit GenePanel
• Gene Library
17
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
81248
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• DNA Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit
• Custom Gene Panel
• Gene Library
• Index Adaptor
81248
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• DNA Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit
• Custom Gene Panel
• Gene Library
• Index Adaptor
18
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
81249
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Gene Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit
• Gene Panel
• Gene Library
81258
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• DNA Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit
• Custom Gene Panel
• Gene Library
• Index Adaptor
81259
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Gene Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit
• Gene Panel
• Gene Library
19
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
81269
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.50 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Gene Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• MLPA Reagents
• Rnase A (1 ML of 4MG/1ML Solution)
• MLPA P140 HBA Probe Mix
81283
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.07 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Gene Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
81334
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.5 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Gene Sequencer
• Other Equipment
• DNA Recovery- Blood Sample
• Reagent Kit
• Custom Gene Panel
• Gene Library
• Index Adaptor
20
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
81520
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 11.00 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• nCounter DX Analysis System
• Other Equipment
• High Pure FFPE RNA Iso Kit
• Prosigna Kit- Required Reagents
81521
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 11.00 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• nCounter DX Analysis System
• Other Equipment
• High Pure FFPE RNA Iso Kit
• MammaPrint Kit
81541
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 11.00 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• nCounter DX Analysis System
• Other Equipment
• High Pure FFPE RNA Iso Kit
• Prolaris Kit
21
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
81551
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 11.00 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• nCounter DX Analysis System
• Other Equipment
• High Pure FFPE RNA Iso Kit
• Confirm MDX Kit
86008
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 0.13 0.05 • Allergy Analyzer
• ELISA Kit
86794
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 0.13 0.05 • Allergy Analyzer
• ZIKA Elisa Kit
87634
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.07 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Other Equipment
• RSV Swab Kit
• Oral Swab RNA Isolation Kit
22
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
87662
Medical and Clinical
Laboratory Technicians 29-
2012
$20.16 1.07 0.05
• Compound Microscope
• PCR Thermocycler
• Centrifuge
• pH meter
• Freezer
• Fridge
• Autoclave
• Other Equipment
• DNA/RNA Recovery- Blood Sample
93792 Physicians and Surgeons, All Other 29-1069
$115.17 0.00 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
93793 Payroll and
Timekeeping Clerks 43-3051
$21.75 0.07 0.17 • No special
equipment
94617
Respiratory Therapists 29-1126
$28.82 0.42 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
• Pulse Oximeter
• Electrocardiograph Machine
• Treadmill
Respiratory Therapy
Technicians 29-2054
$19.69 0.50 0.17
23
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
94618
Cardiovascular Technologists and Technicians 29-
2031
$32.94 0.10 0.08
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
• Treadmill
• Pulse Monitor
• Spirometer
Respiratory Therapy
Technicians 29-2054
$19.69 0.17 0.08
95249 Registered Nurses
29-1141 $33.92 0.20 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
96573
Physicians and Surgeons, All Other 29-1069
$115.17 0.25 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
• Phototherapy Light
Nursing Assistants 31-1014
$14.49 0.50 0.17
96574
Physicians and Surgeons, All Other 29-1069
$115.17 0.33 0.25
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
Nursing Assistants 31-1014
$14.49 1.25 0.33
24
Proc Code BLS Position(s)
BLS Wage(s) (Not Including
Taxes and Benefits)
Expected Direct Care Hours per procedure
Expected Indirect Care
Hours per procedure Capital Included
97763
Orthotists and Prosthetists
29-2091 $27.75 0.25 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
Occupational Therapy Aides
31-2012 $15.15 0.08 0.08
C9738 Physicians and Surgeons, All Other 29-1069
$115.17 0.12 0.17
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale
G0515 Occupational
Therapists 29-1122
$41.55 0.20 0.05
• Stethoscope
• Exam Table
• Exam Chair
• Sphygmomanometer
• Exam Lights
• Otoscope
• Reflex Hammer
• Thermometer
• Scale