45 CFR § 180 compliance
C · 70
This hospital published part of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
○Discounted cash price: below assessment threshold
●Payer-specific negotiated rates: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
78
Insurances with rates
13
CPT / HCPCS codes
53
Most expensive procedures (gross)
4002
—
State Operated Psych Center - Psych Inpatient, Children's
Gross
$3,015
S9485
—
Crisis Intervention - per diem
Gross
$2,381
J1943
—
Aristada Initio - Aripiprazole lauroxil-675mg/2.4ml
Gross
$2,194
J2798
—
Perseris - Risperidone SQ-90MG/0.6ML
Gross
$2,191
J0401
—
Abilify Maintena - 300 mg
Gross
$2,181
4508
—
Full Rate - Upstate
Gross
$2,112
J1944
—
Aristada - Aripiprazole lauroxil-441mg/1.6ml
Gross
$1,462
4001
—
State Operated Psych Center - Psych Inpatient, Adult
Gross
$1,348
4509
—
Partial Rate - Upstate
Gross
$1,056
S9484
—
Crisis Intervention - per hour
Gross
$992
4627
—
Children's Crisis
Gross
$914
J2426
—
Invega Sustenna - Paliperidone palmitate-39MG/0.25ML
Gross
$588
J2358
—
Zyprexa Relprevv - Olanzapine pamoate
Gross
$547
90847
—
Psychotherapy - Family&Client 1 hr
Gross
$510
96116
—
Psychological Testing - Neurobehavioral First Hour
Gross
$510
99215 + 90836 (G0463 for Medicare FFS and Medicare Advantage)
—
Office or Other Outpatient Visit with Psychotherapy (> 45 mins)
Gross
$510
90791
—
Psychiatric Diagnostic Evaluation (minimum 45 mins)
Gross
$425
90792
—
Psychiatric Diagnostic Evaluation with Medical Services (minimum 45 mins)
Gross
$425
99214 + 90833 (G0463 for Medicare FFS and Medicare Advantage)
—
Office or Other Outpatient Visit with Psychotherapy (30-44 mins)
Gross
$425
4060
—
Full
Gross
$375
4063
—
Home Visit
Gross
$375
4064
—
Crisis
Gross
$375
4065
—
Pre-admission, Full Day
Gross
$375
90834
—
Psychotherapy - Indiv 45 (38-52) mins
Gross
$340
96112
—
Developmental Testing - First Hour
Gross
$340
96136
—
Psychological Testing Admin and Scoring - First 30 mins
Gross
$340
G0451
—
Developmental Testing - limited (Replaces code 96110 for Medicare ONLY)
Gross
$340
96132
—
Psychological Testing - Various, maximum of 1 unit
Gross
$275
99382
—
New Patient - Initial comprehensive preventive medicine early childhood (< 5 years)
Gross
$272
G0463
—
Evaluation & Management Services (E/M)
Gross
$272
99383
—
New Patient - Initial comprehensive preventive medicine late childhood (5-11 years)
Gross
$272
99384
—
New Patient - Initial comprehensive preventive medicine adolescent (12-17 years)
Gross
$272
99385
—
New Patient - Initial comprehensive preventive medicine (18-39 years)
Gross
$272
99386
—
New Patient - Initial comprehensive preventive medicine (40-64 years)
Gross
$272
99387
—
New Patient - Initial comprehensive preventive medicine (65+ years)
Gross
$272
99393
—
Established Patient - Periodic comprehensive preventive medicine late childhood (5-11 years)
Gross
$272
99394
—
Established Patient - Periodic comprehensive preventive medicine adolescent (12-17 years)
Gross
$272
99395
—
Established Patient - Periodic comprehensive preventive medicine (18-39 years)
Gross
$272
99396
—
Established Patient - Periodic comprehensive preventive medicine (40-64 years)
Gross
$272
99397
—
Established Patient - Periodic comprehensive preventive medicine (65+ years)
Gross
$272
99202 (G0463 for Medicare FFS and Medicare Advantage)
—
New Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Other Outp
Gross
$272
99203 (G0463 for Medicare FFS and Medicare Advantage)
—
New Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Other Outp
Gross
$272
99204 (G0463 for Medicare FFS and Medicare Advantage)
—
New Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Other Outp
Gross
$272
99205 (G0463 for Medicare FFS and Medicare Advantage)
—
New Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Other Outp
Gross
$272
99212 (G0463 for Medicare FFS and Medicare Advantage)
—
Established Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Ot
Gross
$272
99213 (G0463 for Medicare FFS and Medicare Advantage)
—
Established Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Ot
Gross
$272
99214 (G0463 for Medicare FFS and Medicare Advantage)
—
Established Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Ot
Gross
$272
99215 (G0463 for Medicare FFS and Medicare Advantage)
—
Established Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Ot
Gross
$272
J2794
—
Risperdal Consta - Risperidone microspheres IM-12.5MG
Gross
$270
90832
—
Psychotherapy - Indiv 30 minutes min ( Medicare 16-37) mins
Gross
$255
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 4002 | State Operated Psych Center - Psych Inpatient, Children's | $3,015 | — | — | — | 1 |
| S9485 | Crisis Intervention - per diem | $2,381 | — | — | — | 8 |
| J1943 | Aristada Initio - Aripiprazole lauroxil-675mg/2.4ml | $2,194 | — | — | — | 14 |
| J2798 | Perseris - Risperidone SQ-90MG/0.6ML | $2,191 | — | — | — | 14 |
| J0401 | Abilify Maintena - 300 mg | $2,181 | — | — | — | 14 |
| 4508 | Full Rate - Upstate | $2,112 | — | — | — | 8 |
| J1944 | Aristada - Aripiprazole lauroxil-441mg/1.6ml | $1,462 | — | — | — | 14 |
| 4001 | State Operated Psych Center - Psych Inpatient, Adult | $1,348 | — | — | — | 2 |
| 4509 | Partial Rate - Upstate | $1,056 | — | — | — | 8 |
| S9484 | Crisis Intervention - per hour | $992 | — | — | — | 8 |
| 4627 | Children's Crisis | $914 | — | — | — | 7 |
| J2426 | Invega Sustenna - Paliperidone palmitate-39MG/0.25ML | $588 | — | — | — | 14 |
| J2358 | Zyprexa Relprevv - Olanzapine pamoate | $547 | — | — | — | 9 |
| 90847 | Psychotherapy - Family&Client 1 hr | $510 | — | — | — | 14 |
| 96116 | Psychological Testing - Neurobehavioral First Hour | $510 | — | — | — | 14 |
| 99215 + 90836 (G0463 for Medicare FFS and Medicare Advantage) | Office or Other Outpatient Visit with Psychotherapy (> 45 mins) | $510 | — | — | — | 14 |
| 90791 | Psychiatric Diagnostic Evaluation (minimum 45 mins) | $425 | — | — | — | 14 |
| 90792 | Psychiatric Diagnostic Evaluation with Medical Services (minimum 45 mins) | $425 | — | — | — | 14 |
| 99214 + 90833 (G0463 for Medicare FFS and Medicare Advantage) | Office or Other Outpatient Visit with Psychotherapy (30-44 mins) | $425 | — | — | — | 14 |
| 4060 | Full | $375 | — | — | — | 5 |
| 4063 | Home Visit | $375 | — | — | — | 5 |
| 4064 | Crisis | $375 | — | — | — | 5 |
| 4065 | Pre-admission, Full Day | $375 | — | — | — | 5 |
| 90834 | Psychotherapy - Indiv 45 (38-52) mins | $340 | — | — | — | 14 |
| 96112 | Developmental Testing - First Hour | $340 | — | — | — | 14 |
| 96136 | Psychological Testing Admin and Scoring - First 30 mins | $340 | — | — | — | 14 |
| G0451 | Developmental Testing - limited (Replaces code 96110 for Medicare ONLY) | $340 | — | — | — | 14 |
| 96132 | Psychological Testing - Various, maximum of 1 unit | $275 | — | — | — | 14 |
| 99382 | New Patient - Initial comprehensive preventive medicine early childhood (< 5 years) | $272 | — | — | — | 8 |
| G0463 | Evaluation & Management Services (E/M) | $272 | — | — | — | 14 |
| 99383 | New Patient - Initial comprehensive preventive medicine late childhood (5-11 years) | $272 | — | — | — | 8 |
| 99384 | New Patient - Initial comprehensive preventive medicine adolescent (12-17 years) | $272 | — | — | — | 8 |
| 99385 | New Patient - Initial comprehensive preventive medicine (18-39 years) | $272 | — | — | — | 8 |
| 99386 | New Patient - Initial comprehensive preventive medicine (40-64 years) | $272 | — | — | — | 8 |
| 99387 | New Patient - Initial comprehensive preventive medicine (65+ years) | $272 | — | — | — | 8 |
| 99393 | Established Patient - Periodic comprehensive preventive medicine late childhood (5-11 years) | $272 | — | — | — | 8 |
| 99394 | Established Patient - Periodic comprehensive preventive medicine adolescent (12-17 years) | $272 | — | — | — | 8 |
| 99395 | Established Patient - Periodic comprehensive preventive medicine (18-39 years) | $272 | — | — | — | 8 |
| 99396 | Established Patient - Periodic comprehensive preventive medicine (40-64 years) | $272 | — | — | — | 8 |
| 99397 | Established Patient - Periodic comprehensive preventive medicine (65+ years) | $272 | — | — | — | 8 |
| 99202 (G0463 for Medicare FFS and Medicare Advantage) | New Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Other Outp | $272 | — | — | — | 14 |
| 99203 (G0463 for Medicare FFS and Medicare Advantage) | New Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Other Outp | $272 | — | — | — | 14 |
| 99204 (G0463 for Medicare FFS and Medicare Advantage) | New Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Other Outp | $272 | — | — | — | 14 |
| 99205 (G0463 for Medicare FFS and Medicare Advantage) | New Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Other Outp | $272 | — | — | — | 14 |
| 99212 (G0463 for Medicare FFS and Medicare Advantage) | Established Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Ot | $272 | — | — | — | 14 |
| 99213 (G0463 for Medicare FFS and Medicare Advantage) | Established Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Ot | $272 | — | — | — | 14 |
| 99214 (G0463 for Medicare FFS and Medicare Advantage) | Established Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Ot | $272 | — | — | — | 14 |
| 99215 (G0463 for Medicare FFS and Medicare Advantage) | Established Patient -- Psychotropic Medication Treatment or Psychiatric Consultation or Office or Ot | $272 | — | — | — | 14 |
| J2794 | Risperdal Consta - Risperidone microspheres IM-12.5MG | $270 | — | — | — | 14 |
| 90832 | Psychotherapy - Indiv 30 minutes min ( Medicare 16-37) mins | $255 | — | — | — | 14 |
Showing top 50 of 78 priced procedures, sorted by gross charge.
Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.