Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth	

MASSHEALTH
TRANSMITTAL LETTER AOH-7
 September 2005

	TO:	Acute Outpatient Hospitals and Hospital Licensed Health Centers Participating in MassHealth

	FROM:	Beth Waldman, Medicaid Director

RE:		Acute Outpatient Hospital Manual (Revised Service Codes and Appendix F)

This letter transmits revisions to the service codes and descriptions in Subchapter 6 of the Acute Outpatient Hospital Manual and updates billing information for acute outpatient hospitals (AOHs), including their hospital-licensed health centers and provider-based satellites.  An updated Appendix F, which describes the revenue codes and billing combinations, is also attached.

Revised Subchapter 6 (Service Codes)

Providers should use the revised Subchapter 6 along with the American Medical Association Current Procedural Terminology (CPT) 2005 Health Care Procedure Coding System (HCPCS) level II code books.  Subchapter 6 of the Acute Outpatient Hospital Manual has been completely revised and now contains the following information:

•	CPT codes that are not billable under the MassHealth acute outpatient hospital program (all other CPT codes in the CPT 2005 code book are billable, subject to all limitations and conditions of payment in MassHealth regulations at 130 CMR 410.000 and 450.000); and

•	Level II HCPCS that are billable under the MassHealth acute outpatient hospital program.

The revised Subchapter 6 applies only when billing for services that are reimbursed either according to the Payment Amount Per Episode (PAPE) methodology, or according to the Division of Health Care Finance and Policy (DHCFP) Clinical Laboratory Fee Schedule (114.3 CMR 20.00).  The revised Subchapter 6 is effective for all claims with dates of service on or after May 15, 2005.

MassHealth providers must refer to the official list of CPT and HCPCS codes with descriptions as posted on the Centers for Medicare and Medicaid Services Web site at www.cms.gov/medicare/hcpcs when billing for services provided to MassHealth members.  

For outpatient hospital services that are not reimbursed according to the PAPE methodology or according to the DHCFP Clinical Laboratory Fee Schedule, AOHs must refer to the MassHealth provider manuals listed below to determine which services are payable and which are not payable.

Adult Day Health – AOHs billing for adult day health services must refer to Subchapter 6 of the Adult Day Health Manual.

Adult Foster Care – AOHs billing for adult foster care services must refer to Subchapter 6 of the Adult Foster Care Manual.

Ambulance Services – AOHs billing for ambulance services must refer to Subchapter 6 of the Transportation Manual.

Dental Services – AOHs billing for dental services must refer to Subchapter 6 of the Dental Manual except when the conditions in 130 CMR 420.429(A) or (D) apply.  In those instances, AOHs should refer to Subchapter 6 of the Acute Outpatient Hospital Manual. 

Early Intervention Program – AOHs billing for early intervention program services must refer to Subchapter 6 in the Early Intervention Program Manual.

Hearing Aid Dispensing – AOHs billing for the dispensing of hearing aids must refer to Subchapter 6 of the Hearing Instrument Specialist Manual.

Home Health Services – AOHs billing for home health services must refer to Subchapter 6 of the Home Health Agency Manual.

Physician Services –- AOHs billing for hospital-based physician or entity services must refer to Subchapter 6 of the Physician Manual. 

Psychiatric Day Treatment Program – AOHs billing for psychiatric day treatment programs must refer to Subchapter 6 of the Psychiatric Day Treatment Program Manual.

The Norplant System – AOHs billing for the Norplant System must refer to Subchapter 6 of the Physician Manual. 

Vision Care Materials Dispensing – AOHs billing for the dispensing of ophthalmic materials must refer to Subchapter 6 of the Vision Care Manual.

Prior-authorization requests may be submitted to MassHealth for any medically necessary service for a MassHealth Standard member less than 21 years of age.  For more information on reimbursement for AOH services, providers should refer to the Hospital Rate Year (HRY) 2005 Acute Hospital Request for Application (RFA).  Hospitals can locate the HRY 2005 RFA as well as regulatory and billing information on the MassHealth Web site at: www.mass.gov/masshealth. 

Surgical Pathology HCPCS and Rates

For HRY 2004, AOHs must refer to DHCFP’s Surgical and Related Anesthesia Fee Schedule (114.3 CMR 16.00) for cytopathology service rates.  These rates apply to HCPCS codes in the 88104-88199 range.

Providers are reminded that when billing using the 837 Institutional (837I) claim format, they must use HIPAA-compliant four-digit revenue codes.  Providers billing on the paper UB-92 claims or on the MassHealth-proprietary EMC format must continue to use three-digit revenue codes.

Questions

If you have any questions about the information in this transmittal letter, please contact 
MassHealth Customer Service at 1-800-841-2900, e-mail your inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974.  

NEW MATERIAL
(The pages listed here contain new or revised language.)

Acute Outpatient Hospital Manual

Pages 6-1 through 6-4 and F-1 through F-6

OBSOLETE MATERIAL
(The pages listed here are no longer in effect.)

Acute Outpatient Hospital Manual

Pages 6.1-1 through 6.1-32, 6.2-1 through 6.2-134, 6.3-1 through 6.3-24, 6.4-1 through 6.4-36, and 6.5-1 through 6.5-4 — transmitted by Transmittal Letter AOH-4

Pages F-1 through F-6 — transmitted by Transmittal Letter AOH-6

601  Introduction

MassHealth providers must refer to the official list of HCPCS codes and descriptions as posted on the Centers for Medicare and Medicaid Services Web site at www.cms.gov/medicare/hcpcs when billing for services provided to MassHealth members.  

CPT Codes

MassHealth pays for services billed using all medicine, radiology, laboratory, surgery, and anesthesia CPT codes in effect at the time of service, except for those codes listed in Section 602 of this subchapter, subject to all conditions and limitations described in MassHealth’s regulations at 130 CMR 410.000 and 450.000, and in the most current Acute Hospital Request for Application.   

Level II HCPCS Codes

MassHealth pays for services billed using all Level II HCPCS codes in effect at the time of service listed in Section 603 of this subchapter, subject to all conditions and limitations described in MassHealth’s regulations at 130 CMR 410.000 and 450.000, and in the most current Acute Hospital Request for Application.   

For a list of billable revenue codes and HCPCS billing combinations, please refer to Appendix F of the Acute Outpatient Hospital Manual.  The list in Appendix F is to be used only as a guide.

602  Nonpayable Services - CPT  

MassHealth does not pay for services billed under the following codes.  For members under age 21, MassHealth regulations at 130 CMR 450.144(A) allow providers to seek coverage when medically necessary, by requesting prior authorization.

0001F
0002F
0003F
0004F
0005F
0006F
0007F
0008F
0009F
0010F
0011F
0008T
0010T
0016T
0017T
0018T
0019T
0020T
0021T
0023T
0030T
0031T
0032T
0033T
0034T
0035T
0036T
0037T
0038T
0039T
0040T
0041T
0042T
0043T
0044T
0045T
0046T
0047T
0048T
0049T
0050T
0051T
0052T
0053T
0054T
0055T
0056T
0057T
0058T
0059T
0060T
0061T
0062T
0063T
0064T
0065T
0066T
0067T
0068T
0069T
0070T
0071T
0072T
0073T
0074T
0075T
0076T
0077T
0078T
0079T
0080T
0081T
0082T
0083T
0084T
0085T
0086T
0087T
0088T
10040
11922
11950
11951
11952
11954
15775
15776
15780
15781
15782
15783
15786
15787
15788
15789
15792
15793
15810
15811
15819
15824
15825
15826
15828
15829
15876
15877
15878
15879
17340
17360
17380
19316
19324
19325
19355
19370
19371
19396
20930
20936
21120
21121
21122
21123
21125
21127
21245
21246
21248
21249
22841
32491
32850
32851
32852
32853
32854
32855
32856
33930
33933
33935
33940
33944
33945
34803
36415
36416
36468
36469
36540
37765
37766
41870
41872
43644
43645
43752
43842
43843
43845
44132
44133
44135
44136
44137
47133
47143
47144
47145
44720
44721
47135
47136
47140
47141
47142
47146
47147
48160
48551
48552
48554
48556
50320
50323
50325
50327
50328
50329
50340
50360
50365
50370
50380
58750
58752
58760
58956
58970
58974
58976
59070
59072
59412
59897
62287
63043
63044
65760
65765
65767
65771
65780
65781
65782
69090
71552
72159
72198
73225
76082
76083
76085
76093
76094
76140
76150
76350
76390
76400
76496
76497
76498
77399
78267
78268
78351
80500
80502
82075
82962
84061
84830
86079
86585
86890
86891
86910
86911
86927
86930
86931
86932
86945
86950
86965
86985
87903
87904
88000
88005
88007
88012
88014
88016
88020
88025
88027
88028
88029
88036
88037
88040
88045
88099
88125
89250
89251
89252
89253
89254
89255
89256
89257
89258
89259
89260
89261
89264
89268
89272
89280
89281
89290
89291
89300
89310
89320
89321
89325
89329
89330
89335
89342
89343
89344
89346
89352
89353
89354
89356
90281
90283
90287
90379
90384
90386
90389
90396
90586
90633
90634
90636
90645
90646
90647
90648
90665
90669
90680
90698
90700
90701
90702
90708
90710
90712
90715
90718
90720
90721
90723
90744
90748
90816
90817
90818
90819
90821
90822
90823
90824
90826
90827
90828
90829
90845
90865
90875
90876
90880
90885
90889
90901
90911
90939
90940
90989
90993
90997
90999
91132
91133
92314
92315
92316
92317
92325
92330
92335
92352
92353
92354
92355
92358
92371
92390
92391
92392
92393
92395
92396
92531
92532
92533
92534
92548
92559
92560
92561
92562
92564
93660
93760
93762
93770
93784
93786
93788
93790
94015
95052
95120
95125
95130
95131
95132
95133
95134
95824
95965
95966
95967
96000
96001
96002
96003
96004
96150
96151
96152
96153
96154
96155
96567
96902
97005
97006
97537
97545
97546
97597
97598
97602
97605
97606
97755
97802
97803
97804
97810
97811
97813
97814
98940
98941
98942
98943
99000
99001
99002
99024
99026
99027
99050
99056
99058
99071
99075
99078
99080
99082
99090
99091
99100
99116
99135
99140
99141
99142
99172
99190
99191
99192
99221
99222
99223
99234
99235
99236
99238
99239
99251
99252
99253
99254
99255
99261
99262
99263
99271
99272
99273
99274
99275
99288
99289
99290
99293
99294
99295
99296
99298
99299
99301
99302
99303
99311
99312
99313
99315
99316
99321
99322
99323
99331
99332
99333
99341
99342
99343
99344
99345
99347
99348
99349
99350
99354
99355
99356
99357
99358
99359
99360
99361
99362
99371
99372
99373
99374
99375
99377
99378
99379
99380
99401
99402
99403
99404
99411
99412
99420
99429
99450
99455
99456
99500
99501
99502
99503
99504
99505
99506
99507
99509
99510
99511
99512
99600
99601
99602

603	Payable Services - Level II HCPCS

The following Level II HCPCS describe services that are covered by MassHealth for AOHs and hospital-licensed health centers (HLHCs).

A4641		 J2270		J9020		J9120		J9217		J9375	
A9500		 J2357		J9031		J9130		J9218		J9380	
A9502		 J2430		J9035		J9140		J9219		J9390	
A9503		 J2469		J9040		J9150		J9230		J9600	
A9505		 J2550		J9041		J9151		J9245		J9999	
J0128		 J2770		J9045		J9160		J9250		Q0081	
J0135		 J3110		J9050		J9165		J9260		S0023	
J0207		 J3396		J9055		J9170		J9265		S0028	
J0475		 J7501		J9060		J9180		J9266		S0077	
J0640		 J7504		J9062		J9181		J9268		S0162	
J0740		 J7505		J9065		J9182		J9270		S2082	
J1094		 J7525		J9070		J9185		J9280		S2083	
J1325		 J8510		J9080		J9190		J9290			
J1327		 J8520		J9090		J9200		J9291			
J1620		 J8521		J9091		J9202		J9293			
J1626		 J8530		J9092		J9206		J9305			
J1742		 J8560		J9093		J9208		J9320			
J1745		 J8600		J9094		J9209		J9340			
J1825		 J8610		J9095		J9211		J9350			
J1830		 J8700		J9096		J9213		J9355			
J1950		 J9000		J9097		J9214		J9357			
J2175		 J9001		J9100		J9215		J9360			
J2260		 J9015		J9110		J9216		J9370			

MassHealth Revenue Codes and HCPCS Combination Guide

The following crosswalk should be used as a guide for acute outpatient hospitals (AOHs), hospital-licensed health centers, and provider-based satellites, when billing MassHealth-covered services. 

For most revenue codes, ranges of HCPCS are listed.  Hospitals should check Subchapter 6 of the Acute Outpatient Hospital Manual to determine if a specific code Within a range is covered by MassHealth, since not all codes in the ranges are payable by MassHealth.

Revenue Code	Description	HCPCS Required?	Allowable HCPCS	
025X Pharmacy	
0250	General	No	N/A	
0251	Generic drugs	No	N/A	
0252	Non-generic drugs	No	N/A	
0253	Take-home drugs	No	N/A	
0254	Drugs incident to other diagnostic services	No	N/A	
0255	Drugs incident to radiology	No	N/A	
0257	Nonprescription drugs	No	N/A	
0258	IV solutions	No	N/A	
026X IV Therapy	
0260	General	Yes	Q0081	
027X Medical/Surgical Supplies and Devices – General	
0270	General	No	N/A	
0271	Non-sterile supply	No	N/A	
0272	Sterile supply	No	N/A	
0273	Take-home supplies	No	N/A	
0274	Prosthetic/orthotic devices	No	N/A	
0275	Pacemaker	No	N/A	
0276	Intraocular lens	No	N/A	
0278	Other implants	No	N/A	
028X Oncology	
0280	General	Yes	Within 99201 – 99290 range	
029X DME	
0290	General	No	N/A	
0291	Rental	No	N/A	
0292	Purchase of new DME	No	N/A	
0293	Purchase of used DME	No	N/A	
030X Laboratory	
0300	General	Yes	Within 80048 – 89356 range	
0301	Chemistry	Yes	Within 80048 – 89356 range	
0302	Immunology	Yes	Within 80048 – 89356 range	
0304	Non-routine dialysis	Yes	Within 80048 – 89356 range	
0305	Hematology	Yes	Within 80048 – 89356 range	
0306	Bacteriology and microbiology	Yes	Within 80048 – 89356 range	
0307	Urology	Yes	Within 80048 – 89356 range	
0309	Other	Yes	Within 80048 – 89356 range	
031X Laboratory Pathological – General	
0310	Laboratory pathological – general	Yes	Within 80048 – 89356 range	
0311	Cytology	Yes	Within 80048 – 89356 range	
0312	Histology	Yes	Within 80048 – 89356 range	
0314	Biopsy	Yes	Within 80048 – 89356 range	
0319	Other	Yes	Within 80048 – 89356 range	
032X Radiology – Diagnostic	
0320	General	Yes	Within 70010 – 79999 range	
0321	Angiocardiography	Yes	Within 70010 – 79999 range	
0322	Arthrography	Yes	Within 70010 – 79999 range	
0323	Arteriography	Yes	Within 70010 – 79999 range	
0324	Chest X ray	Yes	Within 70010 – 79999 range	
0329	Other	Yes	Within 70010 – 79999 range	
033X Radiology–Therapeutic and/or Chemotherapy Administration	
0330	General	Yes	Within 70010 – 79999 range	
0331	Chemotherapy administration – injected	Yes	Within 96400 – 96549 range	
0332	Chemotherapy – oral	Yes	Within 96400 – 96549 range	
0333	Radiation therapy	Yes	Within 70010 – 79999 range	
0335	Chemotherapy administration – IV	Yes	Within 96400 – 96549 range	
034X Nuclear Medicine	
0340	General	Yes	Within 70010 – 79999 range	
0341	Diagnostic	Yes	Within 70010 – 79999 range	
0342	Therapeutic	Yes	Within 70010 – 79999 range	
0349	Other	Yes	Within 70010 – 79999 range	
035X Computerized Tomographic (CT) Scans	
0350	General	Yes	Within 70010 – 79999 range	
0351	Head scan	Yes	Within 70010 – 79999 range	
0352	Body scan	Yes	Within 70010 – 79999 range	
0359	Other 	Yes	Within 70010 – 79999 range	
036X Operating Room Services	
0360	General	Yes	Within 10021 – 69990 range, 92018, 92019, and 92502	
0361	Minor surgery	Yes	Within 10021 – 69990 range, 92018, 92019, and 92502	
037X Anesthesia	
0370	General	No	N/A	
0371	Anesthesia incident to radiology	No	N/A	
0372	Anesthesia incident to other diagnostic services	No	N/A	
038X Blood	
0381	Packed red blood cells	No	N/A	
0383	Plasma	No	N/A	
0384	Platelets	No	N/A	
0385	Leukocytes	No	N/A	
0386	Other components	No	N/A	
0387	Other derivatives	No	N/A	
039X Blood Storage and Processing	
0390	General	No	N/A	
0391	Administration	Yes	Within 36430 – 36460 range	
040X Other Imaging Services	
0400	General	Yes	Within 70010 – 79999 range	
0401	Diagnostic mammography	Yes	Within 70010 – 79999 range	
0402	Ultrasound	Yes	Within 70010 – 79999 range	
0403	Screening mammography	Yes	Within 70010 – 79999 range	
0404	Positron emission tomography (PET)	Yes	Within 70010 – 79999 range	
041X Respiratory Services	
0410	General	Yes	Within 94640 – 94668 range	
0412	Inhalation services	Yes	Within 94640 – 94668 range	
0413	Hyperbaric oxygen therapy	Yes	99183	
0419	Other	Yes	Within 94640 – 94668 range	
042X Physical Therapy	
0420	General	Yes	Within 92506 – 92526, 97001 – 97542, and 97703 – 97799 ranges	
0421	Visit charge	Yes	Within 92506 – 92526, 97001 – 97542, and 97703 – 97799 ranges	
0423	Group charge	Yes	Within 92506 – 92526, 97001 – 97542, and 97703 – 97799 ranges	
0424	Evaluation or reevaluation	Yes	Within 92506 – 92526, 97001 – 97542, and 97703 – 97799 ranges	
043X Occupational Therapy	
0430	General	Yes	Within 92506 – 92526, 97001 – 97542, and 97703 – 97799 ranges	
0431	Visit charge	Yes	Within 92506 – 92526, 97001 – 97542, and 97703 – 97799 ranges	
0433	Group rate	Yes	Within 92506 – 92526, 97001 – 97542, and 97703 – 97799 ranges	
0434	Evaluation or reevaluation	Yes	Within 92506 – 92526, 97001 – 97542, and 97703 – 97799 ranges	
044X Speech-Language Pathology	
0440	General	Yes	Within 92504 – 92526, 92601 – 92700, 97001 – 97542, and 97703 – 97799 ranges	
0441	Visit charge	Yes	Within 92504 – 92526, 92601 – 92700, 97001 – 97542, and 97709 – 97799 ranges	
0443	Group rate	Yes	Within 92504 – 92526, 92601 – 92700, 97001 – 97542, and 97709 – 97799 ranges	
0444	Evaluation or reevaluation	Yes	Within 92504 – 92526, 92605 – 92700, 97001 – 97542, and 97703 – 97799 ranges	
045X Emergency Room	
0450	General	Yes	Within 10021 – 69990, 92202 – 92287, and 99241 – 99499 ranges	
0456	Urgent care	Yes	Within 10021 – 69990,  92202 – 92287, and 99241 – 99499 ranges	
0459	Other ER	Yes	Within 10021 – 69990, 92202 – 92287, and 99241 – 99499 ranges	
046X Pulmonary Function	
0460	General	Yes	Within 94010 – 94621 and 94680 – 94799 ranges	
0469	Other	Yes	Within 94010 – 94621 and 94680 – 94799 ranges	
047X Audiology	
0470	General	Yes	Within 92504 – 92597 and 92601 –  92617 ranges	
0471	Diagnostic	Yes	Within 92504 – 92597 and 92601 –  92617 ranges	
0472	Treatment	Yes	Within 92504 – 92597 and 92601 –  92617 ranges	
0479	Other	Yes	Within 92504 – 92597 and 92601 –  92617 ranges	
048X Cardiology	
0480	General	Yes	Within 92950 – 92998 and 93270 – 93668 ranges	
0481	Cardiac catheterization lab	Yes	Within 92950 – 92998 and 93270 – 93668 ranges	
0482	Stress test	Yes	Within 92950 – 92998, 93015 – 93018 and 93270 – 93668 ranges	
0483	Echocardiology	Yes	Within 92950 – 92998 and 93270 – 93668 ranges	
0489	Other	Yes	Within 92950 – 92998 and 93270 – 93668 ranges	
049X Ambulatory Surgical Care	
0490	General	Yes	Within 10021 – 69990 range and 92018, 92019 and 92502	
0499	Other	Yes	Within 10021 – 69990 range and 92018, 92019, and 92502	
051X Clinic	
0510	General	Yes	Within 10021 – 69990, 92002 – 92499, 95115 – 95250, 99201 – 99215, and 99241 – 99499 ranges	
 0515	Pediatric clinic	Yes	Within 10021 – 69990, 92002 – 92499, 95115 – 95250, 99201 – 99215, and 99381 – 99499 ranges	
0519	Other	Yes	Within 10021 – 69990, 92002 – 92499, 95115 – 95250, 99201 – 99215 and 99381 – 99499 ranges	
053X Osteopathic Services	
0530	General	Yes	Within 98925 – 98929 range	
061X Magnetic Resonance Technology	
0610	General	Yes	Within 70010 – 79999 range	
0611	MRI – brain	Yes	Within 70010 – 79999 range	
0612	MRI – spinal cord	Yes	Within 70010 – 79999 range	
062X Medical/Surgical Supplies	
0621	Supplies incident to radiology	No	N/A	
0622	Supplies incident to other diagnostic services	No	N/A	
063X Pharmacy	
0634	EPO, less than 10,000 units	No	N/A	
0635	EPO, 10,000 or more units	No	N/A	
0636	Drugs requiring detail coding	Yes	Within J0120 – J9999, 90281 – 90399, and 90476 – 90749 ranges	
070X Cast Room	
0700	General	Yes	Within 10021 – 69999 range	
071X Recovery Room	
0710	General	No	N/A	
072X Labor Room/Delivery	
0720	General	Yes	Within 10021 – 69999 range	
0721	Labor	Yes	Within 10021 – 69999 range	
0722	Delivery	Yes	Within 10021 – 69999 range	
073X EKG/ECG	
0730	General	Yes	Within 93000 – 93014 and 93024 – 93278 range	
0731	Holter monitor	Yes	Within 93000 – 93014 and 93024 – 93278 range	
0732	Telemetry	Yes	Within 93000 – 93014 and 93024 – 93278 range	
074X EEG	
0740	General	Yes	Within 93000 – 96004 range	
075X Gastroenterology	
0750	General	Yes	Within 91000 – 91299 range	
760X Treatment/Observation Room	
0761	Treatment room	Yes	Within 10021 – 69990, 90202 – 92287, 99201 – 99215, and 99381 – 99499 ranges	
0762	Observation room	Yes	99217 – 99220 range	
077X Preventive Services	
0771	Vaccine administration	Yes	Within 90471 – 90474 range	
082X Hemodialysis	
0820	General	Yes	Within 90918 – 90999 range	
0821	Hemodialysis composite/other rate	Yes	Within 90918 – 90999 range	
083X Peritoneal Dialysis	
0830	General	Yes	Within 90918 – 90999 range	
0831	Peritoneal composite/other rate	Yes	Within 90918 – 90999 range	
084X CAPD	
0840	General	Yes	Within 90918 – 90999 range	
0841	CAPD composite/other rate	Yes	Within 90918 – 90999 range	
085X CCPD	
0850	General	Yes	Within 90918 – 90999 range	
0851	CCPD composite/other rate	Yes	Within 90918 – 90999 range	
090X Behavioral Health Treatments/Services	
0900	General	Yes	Within 90801 – 90911 range	
0901	Electroshock therapy	Yes	Within 90801 – 90911 range	
091X Behavioral Health Treatments/Service	
0914	Individual therapy	Yes	Within 96150 – 96155 range	
0918	Testing	Yes	Within 96100 – 96117 range	
092X Other Diagnostic Services	
0920	General	Yes	Within 92002 – 96004 range and 99170	
0921	Peripheral vascular lab	Yes	Within 93668 – 93990 range	
0922	Electromyelogram	Yes	Within 95860 – 96004 range	
0924	Allergy testing	Yes	Within 95004 – 95078 range	
094X Other Therapeutic Services	
0940	General	Yes	Within 90780 – 90799, 95990 – 95999, 96567 – 96999, and 99173 – 99199 ranges	
0943	Cardiac rehabilitation 	Yes	93797, 93798	
0944	Drug rehabilitation	Yes	Within 90801 – 90862 range	
0945	Alcohol rehabilitation	Yes	Within 90801 – 90862 range	

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