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	CLIA Waiver	Practice Standards	Reporting	Reimbursement

All other facilities that offer laboratory testing, holding a permit issued by the NYSDOH Clinical Laboratory Evaluation Program (CLEP) in the category of Toxicology -Blood Lead.

4 Accessing Medicaid reimbursement

Lead testing is a billable fee-for-service to Medicaid using CPT-4 procedure code 83655. The maximum reimbursable amount for this procedure code is $15.00. Blood-lead tests are carved out of Ambulatory Patient Groups (APGs) and must be billed fee-for-service to Medicaid, by the free-standing diagnostic and treatment centers and hospital out-patient department clinics, using the ordered ambulatory fee schedule.

• Link to NYSDOH site related to Ambulatory Care Payment Reform - Ambulatory Patient Groups (APGs)
• Download Policy and Billing Guidance Ambulatory Patient Groups (APGs) Provider Manual, updated July 1, 2009

Questions you may have on APG implementation may be directed as follows:

For Issues/Questions Regarding	Please Contact
General Policy, Rates, Weights Carve Outs Payment Rules Implementation Issues	NYS Department of Health Office of Health Insurance Programs Div. of Financial Planning and Policy 518-473-2160 apg@health.state.ny.us
Billing Questions Remittance Questions Onsite Training re: Billing	Computer Sciences Corporation eMedNY Call Center 1-800-343-9000 eMedNYProviderRelations@csc.com
Questions Grouper Software/Pricer Product Support 3M HIS Sales	3-M Health Information Systems, Inc. 1-800-435-7776 1-800-367-2447 www.3mhis.com

To purchase a LeadCare II system, call (800) 305.0197