Macon County Public Health Fee Schedule

Modifier

Code

Description

Fees Beginning
July 2016

J0133
J0456
J0696
J1050
J1725
J2790
J7297
J7298
J7300
J7302
J7307
S0030
2000F
11981
11982
11983
54050
54065

Doxycycline/Acyclovir
Azithromax
Ceftriazone
Injection,MedroxyprogesteroneAcetate,150MG(.34perunit)
17PInjection
Rho(D)ImmuneGlobulin(Rhlg),fulldose,300mcg
Liletta
Mirena(replacesJ7302)
Intrauterinecoppercontraceptivedevice,ParagardT380A
Levonorgestrelreleasingintrauterinecontraceptivesystem,52mg(Mirena)
Nexplanon
Metronidazole
BPVMeasurementofocularbloodflowwithinterpretation
Nexplanoninsertion
Nexplanonremoval
Nexplanonremovalwithreinsertion
DestroyPenisLesion(s)SimpleChemical
DestructionPenisLesion(s)ExtensiveCryosurgery

0.00
0.00
0.00
51.00
21.00
134.00

56501
56515
57170
57452

229.00
394.00
91.00
191.00

57455

TCA Vulva
Destroy Vulva Lesion(s) - Complex
Diaphragm fitting with instructions
Colposcopy of the cervix including upper/adjacent vagina
Colposcopy of the cervix including upper/adjacent vagina w/biopsy of cervix or
endocervical curettage
Colposcopy of cervix including upper/adjacent vagina w/biopsy of cervix

57456

Colposcopy of the cervix including upper/adjacent vagina w/endocervical curettage

239.00

58100

Endometrial sampling (biopsy) with or without endocervical sampling

(biopsy), without cervical dilation, any method (separate procedure)

109.00

57454

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

528.00
428.00
528.00
700.00
0.00
5.00
65.00
80.00
145.00
228.00
387.00

269.00
253.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

14.00

50.00
279.00
226.00
364.00

Macon County Public Health Fee Schedule

58300
58301
59025
59425
59426
59430
69210
86580
86580P
G0008
G0009
G0010
Q2038
Q2037
Q2038
Q2039
90471
90472
90473
90474
90621
90632
90633
90636
90645
90646
90647

Modifier

Code

Description

Insert intrauterine device

Removal of IUD
Fetal Non-Stress Test
Prenatal visits: 4 to 6 visits
Prenatal visits: 7 or more visits
After Delivery Care
Remove impacted ear wax
TB Test
TB Test - Patient Pay
Administration Fee - Flu Shot (Medicare)
Administration Fee - Pneumonia Shot (Medicare)
Administration Fee - Hep B (Medicare)
Influenza vaccine quadrivalent 6-36 months
Flu Virus Vaccine (Fluvirin) Medicare
Flu Virus Vaccine (Fluzone) Medicare
Flu Virus Vaccine (Unspecified) Medicare
Vaccine Administration Fee
Vaccine Administration Fee-Each Additional
Immunization administration by intranasal or oral route; one vaccine (single or
combination vaccine/toxoid)
Each additional intranasal or oral route vaccine (single or combination
vaccine/toxoid)
Meningococcal B
Hep A - Adult
Hep A - Pediatric
Twinrix Vaccine
Hib - child - HbOC 4 dose schedule
Hib - Adult - booster only
Hib - PRP_OMP 3 dose schedule

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

132.00
169.00
62.00
1,000.00
1,300.00
121.00
86.00
6.00
6.00
14.00
14.00
14.00
16.00
16.00
16.00
16.00
14.00
14.00
20.00
20.00
125.00
51.00
35.00
66.00
31.00
31.00
31.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

90648
90649
90650
90651
90657
90658
90660
90662
90670
90672
90675
90676
90680
90685
90686
90687
90688
90691
90696
90698
90700
90707
90710
90713
90714

Modifier

Code

Description

Hib - child - PRP-T 4 dose schedule

Gardasil (HPV)
HPV bivalent 2vHPV (Cervarix)
HPV 9 3 dose
Flu Shot (6-35 months)
Flu Shot (3 yrs & >)
Flumist - State Supplied
Fluzone High Dose (65 & >)
Prevnar
Quadrivalent Flu Mist
Rabies Vaccine - Exposure
Rabies Vaccine - Preventive
Rotateq
Influenza virus vaccine,quadrivalent, split virus, preservative free, when
administered to children 6-35 months of age, for intramuscular use
Influenza virus vaccine,quadrivalent, split virus, preservative free, when
administered to individuals 3 years of age and older, for intramuscular use
Influenza virus vaccine,quadrivalent, split virus, when administered to children 6-35
months of age, for intramuscular use
Influenza virus vaccine,quadrivalent, split virus, when administered to individuals 3
years of age and older, for intramuscular use
Typhoid Vaccine
Kinrix - (DTaP-IPV)
Penticil - (DTaP-IPV/Hib)
DTAP
MMR
MMRV
IPV
Td

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

31.00
152.00
137.00
182.00
11.00
11.00
36.00
162.00
40.00
275.00
275.00
81.00
16.00
16.00
16.00
16.00
61.00
55.00
130.00
34.00
65.00
78.00
36.00
31.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

Modifier

Code

Description

90716
90715
90717
90723
90732
90733
90734
90736
90738
90744
90746
92552
92567

Varicella Vaccine
Tdap
Yellow Fever Vaccine
Pediarix - (DTaP- HepB-IPV)
Pneumonia Vaccine
Meningococcal
Menactra
Zostavax (Shingles Vaccine)
Japanese Encephalitis Vaccine
Hep B - Pediatric
Hep B - Adult
Hearing Test
Tympanometry

92587

Evoked otoacoustic emissions; limited (single stimulus level, either transient)

93000

EKG with Interpretation and Report

93010

EKG additional testing

96110
96372
97802
97803
98967
98960
98961
99080
99172
99173
99201

Developmental Screening
Therapeautic Injection
Medical nutrition therapy; initial assessment and intervention, individual,
Medical nutrition therapy; re-assessment and intervention, individual,
Telephone Education, 15 min/unit
Individual Education, face to face
Group Education, face to face
Special reports such as insurance forms & complete physical forms
Visual Acuity Screening Test - Color
Visual Acuity Screening Test
Office Visit (OV) new patient (pt) minor-phys time approx. 10 minutes

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

105.00
41.00
125.00
75.00
75.00
118.00
116.00
190.00
296.00
32.00
50.00
39.00
18.00
63.00
40.00
30.00
13.00
20.00
45.00
22.00
0.00
0.00
0.00
15.00
5.00
5.00
83.00

Macon County Public Health Fee Schedule

99202
99203
99204
99205
99211
99212
99213
99214
99215
99381
99382
99383
99384
99385
99386
99387
G0438
99391
99392
99393
99394
99395
99396
99397
G0439
99406
99407

Modifier

Code

Description

OV new pt, moderate-phys time approx 20 minutes

OV new pt, moderate-phys time approx 30 minutes
OV new pt, complex-phys time approx 45 minutes
OV new pt, severe-phys time approx 60 minutes
OV established (estab) pt, minimal w/wo phys, time approx 5 min (inc limited specialty
PE)

OV estab. pt, minor-phys time approx 10 min. (inc. Employment PE)

OV estab. pt, moderate. phys time approx 15 min. (inc. DOT PE)
OV estab. pt, severe. phys time approx 25 min.
OV estab. pt, severe. phys time approx 40 min.
New Patient (NP) physical exam: < 1 year
NP physical exam: 1 to 4 Years
NP physical exam: 5 to 11 years
NP physical exam: 12 to 17 years
NP physical exam: 18 to 39 years
NP physical exam: 40 to 64 years
NP physical exam: 65 years and over
Initial Visit Medicare Only Once in a lifetime
Established Patient (EP) physical exam: < 1 year
EP physical exam: 1 to 4 years
EP physical exam: 5 through 11 years
EP physical exam: 12 to 17 years
EP physical exam: 18 to 39 years
EP physical exam: 40 to 64 years
EP physical exam: 65 years and older
Medicare Subsequent Annual Wellness Visit
Tobacco Education (3-10 min)
Tobacco Education over 10 min

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

124.00
180.00
280.00
326.00
43.00
72.00
121.00
209.00
262.00
211.00
227.00
226.00
249.00
242.00
287.00
310.00
310.00
200.00
200.00
200.00
216.00
217.00
242.00
250.00
250.00
12.00
23.62

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

99408
99409
99420
99495
99496
99499
99412

Modifier

Code

Description

Substance Abuse
Substance Abuse over 30 min
Additional Assessments
Transitional care management services/moderate
Transitional care management services/high
Other Evaluation and Management Services (Replaced LU202)
Preventive medicine, group counseling, appx 60 minutes

Fees Beginning
July 2016

31.00
63.00
9.00
121.00
209.00
25.00
91.00

DENTAL
D0120
D0140
D0145
D0150
D0160
D0170
D0210
D0220
D0230
D0240
D0250
D0260
D0270
D0272
D0273
D0274
D0330
D1110
D1120

Periodic oral evaluation

Limited oral evaluation - problem focused
Oral Evaluation, pt < 3yrs
Comprehensive oral evaluation - new or established patient
Detailed and extensive oral evaluation - problem focused, by report
Re-evaluation - limited, problem focused (established patient; not post-op)
Intraoral - complete series (including bitewings)
Intraoral -periapical first film
Intraoral - periapical each additional film
Intraoral - occlusal film
Extraoral - first film
Extraoral - each additional film
Bitewing - single film
Bitewings - 2 films
Bitewings - 3 films
Bitewings - 4 films
Panoramic film
Prophylaxis - adult
Prophylaxis - child

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

38.00
66.00
48.00
69.00
100.00
44.00
141.00
30.00
24.00
32.00
42.00
35.00
22.00
36.00
50.00
63.00
116.00
81.00
56.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

D1201
D1205

Modifier

Code

Description

Fees Beginning
July 2016

D1208
D1351
D1510
D1515
D1555
D2140
D2150
D2160
D2161
D2330
D2331
D2332

Topical Fluoride w/ Prophylaxis

Topical Fluoride w/ Prophylaxis
Topical fluoride varnish; therapeutic application for moderate to high caries risk
patients
Topical application of fluoride (prophylaxis not included)
Sealant - per tooth
Space maintainer - fixed - unilateral
Space maintainer - fixed - bilateral
Remove Fix Space Maintainer
Amalgam - 1 surface, primary or permanent
Amalgam - 2 surfaces, primary or permanent
Amalgam - 3 surfaces, primary or permanent
Amalgam - 4 or more surfaces, primary or permanent
Resin-based composite - 1 surface, anterior
Resin-based composite - 2 surfaces, anterior
Resin-based composite - 3 surfaces, anterior

35.00
44.00
283.00
395.00
51.00
95.00
123.00
149.00
181.00
118.00
150.00
184.00

D2335

Resin-based composite - 4 or more surfaces or involving incisal angle (anterior)

217.00

D2336
D2391
D2392
D2393
D2394
D2751
D2910
D2920
D2930
D2940
D2950

Resin based composite - 1 surface pstr perm

Resin-based composite - 1 surface, posterior
Resin-based composite - 2 surfaces, posterior
Resin-based composite - 3 surfaces, posterior
Resin-based composite - 4 or more surfaces, posterior
Crown, non- precious metal (porcelin)
Recement inlay/onlay or part
Recement Crown
Prefabricated stainless steel crown - primary tooth
Sedative filling
Core buildup, including any pins

D1206

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

82.00
82.00
51.00

138.00
138.00
180.00
223.00
275.00
1,000.00
25.00
28.00
223.00
85.00
194.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

D2951
D3220
D3310
D3320
D3330
D4211
D4341
D4342
D4355
D4910
D5110
D5120
D5130
D5140
D5211
D5212
D5213
D5214
D5410
D5411
D5421
D5422
D5510
D5520
D5610
D5640
D5650
D5660

Modifier

Code

Description

Pin retention - per tooth, in addition to restoration

Therapeutic pulpotomy (excluding final restoration)
Root canal therapy - anterior (excluding final restoration)
Root canal therapy - bicuspid (excluding final restoration)
Root canal therapy - molar (excluding final restoration)
Gingivectomy or gingivoplasty 1 to 3 contiguous teeth/quadrant
Periodontal scaling and root planing 4 or more contiguous teeth
Periodontal scaling and root planing 1 to 3 teeth/quadrant
Full mouth debridement to enable comprehensive evaluation and diagnosis
Periodontal Maintenance
Complete Denture - Maxillary
Complete Denture - Mandibular
Immediate Denture - Maxillary
Immediate Denture - Mandibular
Maxillary Partial Denture - Resin Base
Mandibular Partial Denture - Resin Base
Maxillary partial denture - cast metal framework resin base
Mandibular Partial Denture - cast metal framework resin base
Adjust Complete Denture Maxillary
Adjust Complete Denture Mandbular
Adjust Partial Denture Maxillary
Adjust Partial Denture Mandibular
Repair Broken Complete Denture
Replace Missing or Broken Tooth
Repair Resin Denture Base
Replace Broken Teeth
Add tooth to existing partial denture
Add clasp to existing partial denture

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

48.00
138.00
572.00
700.00
869.00
182.00
198.00
188.00
146.00
98.00
1138.00
1138.00
1234.00
1234.00
844.00
844.00
1230.00
1230.00
62.00
62.00
62.00
62.00
150.00
128.00
150.00
128.00
156.00
234.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

Modifier

Code

Description

Fees Beginning
July 2016

D5730
D5731
D5740
D5741
D6930
D7111
D7140
D7210
D7220
D7230
D7240
D7250

Reline Complete Maxillary Denture

Reline Complete Mandibular Denture
Reline Maxillary Partial Denture
Reline Mandibular Partial Denture
Recement bridge
Extraction, coronal remnants - deciduous tooth
Extraction, erupted tooth or exposed root
Surgical removal of erupted tooth
Removal of impacted tooth - soft tissue
Removal of impacted tooth - partially bony
Removal of impacted tooth - completely bony
Surgical removal of residual tooth roots (cutting procedure)

264.00
264.00
258.00
258.00
88.00
92.00
123.00
217.00
271.00
354.00
424.00
234.00

D7310

Alveoloplasty in conjunction with extractions - 4 or more tooth spaces, per quadrant

223.00

D7311

Alveoloplasty in conjunction with extractions 1 to 3 tooth spaces

Alveoloplasty not in conjunction with extractions - 4 or more tooth spaces, per
quadrant

190.00

D7321

Alveoloplasty not in conjunction with extractions - 1 to 3 tooth spaces, per quadrant

308.00

D7410
D7510
D7530
D9110
D9940
LU401

Excision of benign lesion up to 1.25 cm

Incision and drainage of abscess - intraoral soft tissue
Removal of foreign body from mucosa, skin, or subcutaneous tissue
Palliative (emergency) treatment of dental pain - minor procedure
Occlusal Bite Guard
MI Paste

177.56
241.00
250.00
97.00
400.00
12.25

D7320

364.00

OTHER SERVICES
99499
S9982

Lice Treatment
Copy of Medical Records (per sheet charge not to exceed $15.00)

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

0.00
0.25

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

99402
T1001
86580
3510F
3510F
3510F
3510F
LU121
LU122
LU123
LU124
3510F
3510F
3510F
LU265
LU266
LU267
LU268
LU269
LU270
LU271
LU272
LU273
LU274
S9981
LU402
G0431

Modifier

Code

Description

HIV Post-Test Results

TB Screening Form
PPD given, high risk (State Supplied)
PPD, positive result, contact
PPD, negative result, contact
PPD, positive result, low risk
PPD, negative result, low risk
TB Directly Observed Therapy (DOT)
TB Directly Observed Preventive Terapy (DOPT)
PPD, not read, contact
PPD, not read, low risk
PPD, positive result, high risk
PPD, negative result, high risk
PPD, not read, high risk
Treatment of LTBI initiated, high risk
Treatment of LTBI, initiated, low risk
Treatment of LTBI, initiated, contact
Treatment of LTBI completed, high risk
Treatment of LTBI completed, low risk
Treatment of LTBI completed,contact
Treatment of LTBI incomplete
Treatment of LTBI incomplete, low risk
Treatment of LTBI incomplete, contact
PPD given, contact
Miscellaneous Services (ex. Medical records payment from Disability Determination,
shipping charges)
Medicaid Co-Payment
Hair Drug Testing

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

0.00
10.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
15.00
3.00
100.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

Modifier

Code

Description

H0049

Expanded Hair Drug Testing

S0280

Medical home program, comprehensive care coordination and planning, Initial Plan

S0281
T1002

Med home prog, comp care coord and planning, main. of plan (postpartum)
RN Services

G0108
G0109
G0447
G0473
O430T
97802
97803
S9465
S9470

DSMT (Individual) 1/2 Hour Units

DSMT (Group) 1/2 Hour Units
Face To Face Behavioral Counseling for Obesity, Individual, 15 min un
face To Face Behavioral Counseling for Obesity, Group, 30 min un
Diabetes Prevention Program
MNT Individual/Initial (15 Min Units)
MNT Re-Check/Individual (15 Min Units)
Diabetic management program, dietician visit (BCBS)
Nutritional counseling, dietician visit (BCBS)
Baby Think It Over 4 Classes
Body Fat Monitor & Calipers
Body Fat Testing by Calipers
Body Fat Testing by Monitor
BTIO Keys
Challenge Course
CPR Breathing Barriers
Adult 1st Aid / CPR / AED
CPR w/AED (Adult & Child) - ELIMINATED
Adult CPR/AED
Adult & Pediatric CPR/AED
Pediatric CPR/AED

Fees Beginning
July 2016

110.00
50.00
150.00
19.50

HEALTH EDUCATION SERVICES

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

54.00
19.00
25.00
25.00
60.00
28.00
24.00
35.00
35.00
350.00
10.00
7.00
5.00
6.00
10.00
6.00
90.00
0.00
70.00
90.00
70.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

S9445

36415
36416
80048
80050
80051
80053
80055
80061
80069
80074
80076
G0431
80335

Modifier

Code

Description

CPR w/AED (Child) + Infant CPR + FAB - ELIMINATED

CPR w/AED (Adult & Child( + FAB - ELIMINATED
Adult & Pediatric 1st Aid/CPR/AED
First Aid-Basic
Healthy Heart Screening
Individual Health Education
Life Worksite Wellness (A)
Life Worksite Wellness (B)
Life Worksite Wellness (C)
Life Worksite Wellness (D)
Life Worksite Wellness (E)
Locking Clips
Face Shield
LABORATORY
ROUTINE VENIPUNCTURE
CAPILLARY BLOOD DRAW
BMP- METABOLIC PANEL TOTAL CA
GENERAL HEALTH PANEL
ELECTROLYTE PANEL
CMP - COMPREHEN METABOLIC PANEL
PRENATAL - OBSTETRIC PANEL
LIPID PANEL
RENAL FUNCTION PANEL
HEPATITIS PANEL- ACUTE (A,B,C)
HEPATIC FUNCTION PANEL
DRUG SCREEN, QUALITATE/MULTI w/ confirmation (Replaces 80100)
AMITRIPTYLINE (Replaces 80152)

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

0.00
0.00
110.00
70.00
35.50
20.00
40.00
37.50
35.00
32.50
30.00
1.00
2.00

9.00
4.00
27.00
38.00
29.00
29.00
57.00
30.00
29.00
46.00
27.00
50.00
43.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

80156
80157
80158
80162
80164
80177
80178
80184
80185
80188
80195
80197
80198
80299
80300
80301
80302
80303
80304
80320
80335
80336
80337
81001
81002
81003
81025
81220

Modifier

Code

Description

CARBAMAZEPINE, TOTAL- TEGRETOL

TEGRETOL, FREE
CYCLOSPORINE - BLOOD
DIGOXIN
VALPROIC ACID (DIPROPYLACETIC ACID)
LEVETIRACETAM
LITHIUM
PHENOBARBITAL
DILANTIN - PHENYTOIN, TOTAL
PRIMIDONE- MYSOLINE (W/PHENOB)
SIROLIMUS(RAPAMUNE) BLOOD
TACROLIMUS
THEOPHYLLINE
QUANTITATIVE ASSAY DRUG
DRUG SCREEN, QUALITATE/MULTI w/ confirmation (Replaces 80100)
DRUG SCREEN MULTICHANNEL PER DATE OF SERVICE (Replaces 80100)
DRUG SCREEN SINGLE DRUG EACH PROCEDURE (Replaces 80100)
DRUG SCREEN THIN LAYER CHROMATOGRAPHY (Replaces 80100)
DRUG SCREEN NOT OTHERWISE SPECIFIED (Replaces 80100)
DRUG SCREEN - ALCOHOL (Replaces 80101)
ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS 1 OR 2
ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS 3-5
ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS; 6 OR MORE
URINALYSIS, AUTO W/SCOPE"
URINALYSIS NONAUTO W/O SCOPE (P&G)
URINALYSIS, AUTO, W/O SCOPE"
URINE PREGNANCY TEST
CYSTIC FIBROSIS GENE ANALYSIS (CFTR)

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

32.00
70.00
43.00
31.00
30.00
38.00
31.00
39.00
32.00
41.00
49.00
82.00
38.00
137.00
50.00
50.00
50.00
50.00
50.00
73.00
40.00
40.00
40.00
22.00
16.00
17.00
19.00
130.00

Macon County Public Health Fee Schedule

82024
82040
82043
82055
82075
82085
82088
82103
82104
82105
82131
82140
82150
82157
82164
82175
82232
82239
82247
82248
82274
82306
82308
82310
82330
82340
82374
82375

Modifier

Code

Description

ACTH
ALBUMIN
MICROALBUMIN / CREAT RATION - RANDOM URINE
ALCOHOL - BLOOD (ETHANOL)
ALCOHOL- BREATH ETHANOL
ALDOLASE
ALDOSTERONE
ALPHA-1-ANTITRYPSIN, TOTAL"
ALPHA-1-ANTITRYPSIN, PHENOTYPE
ALPHA-FETOPROTEIN, SERUM"
AMINO ACIDS, SINGLE QUANT"
AMMONIA
AMYLASE
ANDROSTENEDIONE
ANGIOTENSIN I ENZYME TEST
ARSENIC
BETA-2 MICROGLOBULIN SERUM
BILE ACIDS, TOTAL
BILIRUBIN, TOTAL"
BILIRUBIN, DIRECT"
FECAL OCCULT BLOOD,IMMUNOASSAY
VITAMIN D
CALCITONIN, SERUM
CALCIUM
CALCIUM- ionized
CALCIUM IN URINE
CARBON DIOXIDE-BLOOD
CARBON MONOXIDE-BLOOD

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

50.00
29.00
34.00
40.00
40.00
28.00
45.00
32.00
45.00
30.00
45.00
38.00
30.00
46.00
31.00
60.00
41.00
37.00
29.00
29.00
50.00
40.00
40.00
29.00
30.00
31.00
36.00
38.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

82378
82380
82384
82390
82435
82436
82465
82491
82542
82507
82523
82530
82533
82550
82552
82553
82565
82570
82575
82595
82607
82627
82668
82670
82672
82677
82705
82710

Modifier

Code

Description

CEA-CARCINOEMBRYONIC ANTIGEN
CAROTENE, BETA
THREE CATECHOLAMINES
CERULOPLASMIN
CHLORIDE-BLOOD
CHLORIDE- URINE
CHOLESTEROL-BLD/SERUM
CHROMOTOGRAPHY, QUANT, SING"
LAMOTRIGINE (LAMICTAL) SERUM
CITRATE - urine 24 hour
COLLAGEN CROSSLINKS
CORTISOL, FREE - URINE 24 HOUR
CORTISOL- TOTAL
CPK TOTAL
CPK ISOENZYMES
CPK, MB FRACTION"
CREATININE
CREATININE- URINE 24 HOUR/RANDOM
CREATININE CLEARANCE TEST
CRYOGLOBULIN- semiquant, REFLEX
VITAMIN B-12
DEHYDROEPIANDROSTERONE- DHEAS
ERYTHROPOIETIN
ESTRADIOL
ESTROGEN
ESTRIOL
FATS/LIPIDS, FECES, QUAL"
FECAL FATS, QUANTITATIVE

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

33.00
37.00
54.00
32.00
29.00
29.00
29.00
125.00
58.00
45.00
125.00
37.00
31.00
25.00
34.00
114.00
25.00
30.00
31.00
29.00
30.00
37.00
32.00
47.00
45.00
20.00
34.00
41.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

82728
82731
82746
82784
82785
82941
82947
82950
82951
82952
82952
82955
82977
82985
83001
83002
83010
83020
83021
83036
83090
83498
83516
83520
83525
83527
83540
83550

Modifier

Code

Description

FERRITIN
FETAL FIBRONECTIN
FOLIC ACID SERUM
GAMMAGLOBULIN IgA, IgD, IgG, IgM, each
GAMMAGLOBULIN IgE
GASTRIN, SERUM
GLUCOSE, BLOOD QUANT"
O'SULLIVAN GLUCOSE TEST
GLUCOSE TOLERANCE TEST (GTT) 2HR
GLUCOSE TOLERANCE TEST -ADDITIONAL specimen
GTT-ADDED SAMPLES
G6PD ENZYME- QUANT
GGT
GLYCATED PROTEIN
FSH- GONADOTROPIN (FSH)
LH - GONADOTROPIN (LH)
HAPTOGLOBIN, QUANT"
SICKLE CELL TO STATE LAB
HEMOGLOBIN CHROMOTOGRAPHY
A1C Hgb - GLYCOSYLATED HEMOGLOBIN TEST
HOMOCYSTINE
HYDROXY-PROGESTERONE, 17-d alpha
IMMUNOASSAY NONANTIBODY
IMMUNOASSAY RIA
INSULIN
INSULIN-FREE
IRON
IRON BINDING TEST

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

26.00
192.00
30.00
25.00
32.00
35.00
18.00
28.00
31.50
10.50
10.50
35.00
29.00
44.00
32.00
35.00
34.00
0.00
86.00
29.00
57.00
45.00
100.00
100.00
30.00
33.00
25.00
10.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

83615
83655
83690
83695
83701
83704
83718
83721
83735
83825
83835
83874
83880
83883
83891
83894
83898
83900
83901
83909
83912
83914
83921
83930
83935
83945
83970
83986

Modifier

Code

Description

LACTATE (LD) (LDH) ENZYME

LEAD (adult)
LIPASE
LIPOPROTEIN(A)
ELECTROPHORETIC SEP & QUANT WITH HR REFRACTION
LIPOPROTEIN PARTICLES-QUANTITATION
HDL- DIRECT LIPOPROTEIN
LDL DIRECT - LIPOPROTEIN
MAGNESIUM
MERCURY
METANEPHRINES- TOTAL - 24 HOUR URINE
MYOGLOBIN- URINE OR SERUM QUANT
BNP- T-TYPE NATRIURETIC PEPTIDE
NEPHELOMETRY NOT SPEC
MOLECULE ISOLATE NUCLEIC
MOLECULE GEL ELECTROPHOR
MOLECULE NUCLEIC AMPLI, EACH"
MOLECULE NUCLEIC AMPLI 2 SEQ
MOLECULE NUCLEIC AMPLI ADDON
SEPARATION+ID BY HIGH RESOLUTION
GENETIC EXAMINATION
MUTATION ID OLA/SBCE/ASPE
ORGANIC ACID, SINGLE, QUANT"
OSMOLALITY- BLOOD
OSMOLALITY- URINE
OXALATE -24 HR URINE
PTH- PARATHYROID HORMONE-INTACT
BODY FLUID ACIDITY Nitrazine paper

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

29.00
29.00
30.00
36.00
45.00
75.00
25.00
29.00
25.00
54.00
49.00
39.00
68.00
40.00
35.00
26.00
26.00
30.00
26.00
15.00
26.00
26.00
125.00
31.00
31.00
36.00
31.00
9.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

84066
84075
84100
84105
84132
84133
84134
84144
84146
84153
84154
84155
84156
84165
84166
84207
84244
84295
84300
84305
84402
84403
84425
84436
84439
84443
84445
84446

Modifier

Code

Description

PROSTATE ACID PHOSPHATASE

ALKALINE PHOSPHATASE
PHOSPHORUS- INORGANIC -SERUM
PHOSPHORUS- INORGANIC - URINE
POTASSIUM- SERUM
POTASSIUM- URINE
PREALBUMIN
PROGESTERONE
PROLACTIN
PSA, TOTAL
PSA, FREE
PROTEIN - TOTAL/REFLECT SERUM
PROTEIN, URINE RANDOM or 24 hour
PROTEIN ELEC-PHORESIS, SERUM QUANT
PROTEIN ELEC-PHORESIS/URINE/CSF
VIT B6 - PLASMA
RENIN
SODIUM- SERUM
SODIUM- URINE 24 HOUR
SOMATOMEDIN
TESTOSTERONE- FREE
TESTOSTERONE- TOTAL
VITAMIN B-1 THIAMINE
T4- TOTAL THYROXINE
T4- FREE THYROXINE
TSH- THYROID STIM HORMONE
TSI-THYROID STIMULATING IMMUNG
VIT E - SERUM

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

32.00
29.00
29.00
29.00
29.00
31.00
33.00
35.00
33.00
30.00
33.00
24.00
29.00
30.00
34.00
49.00
40.00
29.00
29.00
40.00
52.00
32.00
42.00
23.00
27.00
28.00
77.00
37.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

84450
84460
84466
84478
84479
84480
84481
84482
84484
84520
84540
84550
84560
84585
84590
84591
84597
84630
84681
84702
84703
85002
85004
85007
85014
85018
85025
85041

Modifier

Code

Description

AST (SGOT) TRANSFERASE

ALT (SGPT) ALANINE AMINO
TRANSFERRIN
TRIGLYCERIDES
T3 or T4 UPTAKE or THBR
T3- TRIIODOTHYRONINE (T3)
T3-FREE ASSAY (FT-3)
T3- REVERSE
TROPONIN, QUANT"
BUN -UREA NITROGEN
UREA NITROGEN -24 HR URINE
URIC ACID- BLOOD
URIC ACID- URINE
VMA- URINE 24 HOUR
VITAMIN A
Vitamin B7 - Biotin
VIT K - 1
ZINC
C-PEPTIDE
HCG- QUANT SERUM
HCG-QUAL SERUM
BLEEDING TIME TEST
WBC DIFFERENTIAL -AUTOMATED
WBC DIFFERENTIAL- MANUAL bld smear
HEMATOCRIT
HEMOGLOBIN
CBC W/AUTO DIFF WBC
RBC COUNT AUTOMATED

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

29.00
29.00
33.00
29.00
28.00
32.00
34.00
49.00
110.00
29.00
32.00
25.00
29.00
37.00
40.00
125.00
200.00
30.00
32.00
30.00
32.00
40.00
27.00
16.00
18.00
18.00
26.00
31.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

85045
85048
85049
85060
85220
85240
85250
85300
85301
85302
85303
85305
85306
85307
85379
85384
85610
85613
85651
85660
85670
85705
85730
85732
86038
86060
86140
86146

Modifier

Code

Description

RETICULOCYTE COUNT AUTOMATED

WBC-COUNT - BLOOD (LEUKOCYTE ) AUTOMATED
PLATELET COUNT AUTOMATED
BLOOD SMEAR INTERPRETATION
FACTOR V ACTIVITY
FACTOR VIII ACTIVITY
FACTOR IX ACTIVITY
ANTITHROMBIN III TEST
ANTITHROMBIN III ANTIGEN TEST
PROTEIN C ANTIGEN
PROTEIN C ACTIVITY
PROTEIN S, TOTAL
PROTEIN S FREE
ACTIVATED PROTEIN C (ACP) RESISTANCE
FIBRIN DEGRADATION, QUANT"
FIBRINOGEN
PT / INR PROTHROMBIN TIME
RUSSELL VIPER VENOM, DILUTED"
SED RATE, NONAUTOMATED"
SICKLE CELL TEST-RBC REDUCTION-reflex fraction.
THROMBIN TIME PLASMA
THROMBOPLASTIN INHIBITION
PTT- THROMBOPLASTIN TIME, PARTIAL"
THROMBOPLASTIN TIME, SUBSTITUTION EA
ANA- ANTINUCLEAR ANTIBODIES-DIRECT
ANTISTREPTOLYSIN O, TITER"
C-REACTIVE PROTEIN
BETA 2 GLYCOPROTEIN 1 ANTIBODIES, IGG, IGM - Replaces 86142

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

29.00
29.00
29.00
30.00
95.00
95.00
95.00
51.00
43.00
63.00
54.00
61.00
61.00
55.00
45.00
30.00
28.00
54.00
29.00
100.00
44.00
75.00
28.00
75.00
30.00
29.00
30.00
32.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

86141
86147
86160
86162
86200
86215
86225
86226
86235
86255
86256
86300
86300
86301
86304
86308
86334
86335
86336
86340
86359
86360
86376
86382
86431
86480
86580
86592

Modifier

Code

Description

C-REACTIVE PROTEIN, HS - CARDIAC

CARDIOLIPIN ANTIBOD, each class
COMPLEMENT, ANTIGEN"
COMPLEMENT, TOTAL (CH50)"
CCP-CYCLIC CITRULPEPTIDE AB
DNASE (DEOXYRIBONUCLEASE) ANTIBODY
DNA ANTIBODY- NATIVE OR DOUBLE STRAND
DNA ANTIBODY, SINGLE STRAND"
NUCLEAR ANTIGEN ANTIBODY-EXTRACTABLE
FLUORESCENT ANTIBODY, SCREEN"
FLUORESCENT ANTIBODY, TITER"
CA IMMUNOASSAY TUMOR,
CA 27.29 -IMMUNOASSAY TUMOR,
CA 19-9- MMUNOASSAY TUMOR,
CA 125- MUNOASSAY TUMOR,
MONO- HETEROPHILE ANTIBODIES-QUALITATIVE
IMMUNOFIX E-PHORESIS, SERUM"
IMMUNFIX E-PHORSIS/URINE/CSF
INHIBIN A
INTRINSIC FACTOR ANTIBODY
T CELLS; TOTAL COUNT
CD4 / CD8, ABSOLUTE COUNT/RATIO"
MICROSOMAL ANTIBODY
RABIES TITER - NEUTRALIZATION TEST, VIRAL
RA -RHEUMATOID FACTOR, QUANT"
TB- INTERFERON GOLD TEST
TB INTRADERMAL TEST
RPR- BLOOD SEROLOGY, QUALITATIVE"

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

31.00
37.00
33.00
31.00
45.00
42.00
32.00
45.00
34.00
35.00
35.00
38.00
36.00
35.00
33.00
33.00
27.00
51.00
20.00
36.00
35.00
73.00
31.00
70.00
30.00
69.00
6.00
28.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

86593
86611
86617
86618
86632
86644
86645
86663
86664
86665
86677
86689
86694
86695
86696
86701
86703
86704
86705
86706
86707
86708
86709
86735
86747
86757
86762
86765

Modifier

Code

Description

RPR-TITER BLOOD SEROLOGY, QUANT

BARTONELLA ANTIBODY CAT SCRATCH
LYME DISEASE ANTIBODY-CONFIRMATORY WB
LYME DISEASE IGM ANTIBODY
CHLAMYDIA IGM ANTIBODY
CMV ANTIBODY- IGG
CMV ANTIBODY, IGM"
EPSTEIN-BARR ANTIBODY-EA EARLY ANTIGEN
EPSTEIN-BARR ANTIBODY-EBNA NUCLEAR AG
EPSTEIN-BARR ANTIBODY-VIRAL CAPSID(VCA)
HELICOBACTER PYLORI - IGG QUANT
HTLV/HIV WB CONFIRMATORY
HERPES SIMPLEX TEST- TYPE 1 & 2 IGM
HERPES SIMPLEX TYPE 1 IGG
HERPES SIMPLEX TYPE 2
HIV-1
HIV-1/HIV-2, SCREENING
HEP B CORE ANTIBODY, TOTAL"
HEP B CORE ANTIBODY, IGM"
HEP B SURFACE ANTIBODY- QUALITAtive
HEP BE ANTIBODY
HEP A ANTIBODY, TOTAL"
HEP A ANTIBODY, IGM"
MUMPS TITER - IGG ANTIBODY
PARVOVIRUS ANTIBODY-B19 IGG-IGM
RICKETTSIA AB-ROCKY MTN SPOTTED FEVER
RUBELLA ANTIBODY TITER IGG
RUBEOLA ANTIBODY TITER IGG

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

30.00
50.00
58.00
45.00
40.00
31.00
33.00
25.00
25.00
25.00
39.00
70.00
39.00
41.00
44.00
33.00
38.00
32.00
31.00
29.00
33.00
31.00
31.00
32.00
66.00
48.00
30.00
33.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

86777
86780
86787
86790
86800
86803
86804
86850
86870
86880
86900
86901
87045
87070
87071
87075
87077
87081
87086
87088
87149
87168
87172
87177
87186
87205
87207
87209

Modifier

Code

Description

TOXOPLASMA GONDII IGG ANTIBODY

TP-PA SYPHILIS CONFIRM TEST
VARICELLA-ZOSTER ANTIBODY TITER
VIRUS ANTIBODY NOS
THYROGLOBULIN ANTIBODY
HEPATITIS C AB TEST
HEP C AB TEST, CONFIRM"
ANTIBODY SCREEN- RBC
ANTIBODY IDENTIFICATION- RBC
COOMBS TEST, DIRECT"
BLOOD TYPING, ABO"
BLOOD TYPING, RH (D)"
STOOL (FECES) CULTURE to State Lab
CULTURE, BACTERIA, OTHER WITH PRESUMPTIVE ID
CULTURE, BACTERIA, OTHER
CULTURE ANAEROBIC BACTERIA, EXCEPT BLOOD"
CULTURE AEROBIC ORGANISM IDENTIFICATION
CULTURE SCREEN ONLY
URINE CULTURE/COLONY COUNT
URINE BACTERIA CULTURE
CULTURE IDENTIFICATION BY NEUCLEIC ACID
MACROSCOPIC EXAM ARTHROPOD (nits-lice)
PINWORM EXAM
OVA AND PARASITES SMEARS-concentration
SUSCEPTIBLE - MICROBE , MIC"
GRAM STAIN- SMEAR,
SMEAR, SPECIAL STAIN"
SMEAR, COMPLEX STAIN- richrome, iron etc

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

34.00
67.00
34.00
143.00
34.00
31.00
155.00
30.00
42.00
36.00
30.00
38.00
0.00
25.00
25.00
88.00
25.00
25.00
18.00
22.00
25.00
17.00
15.00
30.00
39.00
18.00
119.00
30.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

Code

Modifier

87210
87230
87324
87338
87340
87350
87390
87425
87490
87491
87491
87517
87521
87522
87590
87591
87623
87880
87902
88141
88175
Q0091
89055
89321
99000
99070
G0328
Q0114

WET MOUNT, SALINE/INK"

C.DIFFICILE B TOXIN - (QUAL)
CLOSTRIDIUM difficile toxin A and B, EIA
HELICOBACTER PYLORI, STOOL ANITGEN, EIA
HEPATITIS B SURFACE AG, EIA"
HEPATITIS BE AG, EIA"
HIV-1 AG, EIA - STATE LAB
ROTAVIRUS AG, EIA"
CHLAMYDIA TRACH BY DNA PROBE
CHLAMYDIA TRACH, DNA, TO State Lab
CHLAMYDIA TRACH, DNA, LabCorp swab or ua
HEPATITIS B, DNA, QUANT - PCR
HEPATITIS C, RNA, AMP PROBE - QUAL
HEPATITIS C, RNA, QUANTISURE (IU)
N.GONORRHOEAE, DNA, DIR PROB"
N.GONORRHOEAE, DNA, AMP PROB
HPV, DNA, AMP PROBE" (Replaces 87621)
STREP A ASSAY W/OPTIC
HEPATITIS C GENOTYPE, DNA, "
CYTOPATHOLOGY, CERVICAL OR VAGINAL
90 PAP COLLECTION FEE
PAP COLLECTION FEE - Medicare
WBC - STOOL
SEMEN ANAL, SPERM DETECTION"-AMC
HANDLING FEE
MATERIALS AND SUPPLIES-each container
HEMOCCULTS X 3 (MEDICARE)
FERN TEST

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Description

Fees Beginning
July 2016

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

15.00
40.00
40.00
63.00
29.00
32.00
0.00
38.00
33.00
0.00
30.00
262.00
115.00
115.00
33.00
30.00
40.00
48.00
228.00
20.00
20.00
16.75
33.00
30.00
15.00
7.50
18.00
20.00

Macon County Public Health Fee Schedule

99000
99000

Modifier

Code

Description

Handling Fee/ COC DRUG COLLECTION FEE

Handling Fee / COC PATERNITY COLLECTION

Fees Beginning
July 2016

15.00
15.00

ENVIRONMENTAL HEALTH
On-Site Waste Water (OSWW)

ImprovementPermit(IPOnly)240360Gallonsperday/23Bedrooms

500.00

AuthorizationtoConstruct(ACOnly)240360Gallonsperday/23Bedrooms
IP/AC240360Gallonsperday/23Bedrooms
ImprovementPermit(IPOnly)480600Gallons/45Bedrooms

500.00
500.00
1,000.00

AuthorizationtoConstruct(ACOnly)480600Gallonsperday/45Bedrooms
IP/AC480600Gallonsperday/45Bedrooms
CommercialImprovementPermit(IP)alsoappliestoresidentialover6bedrooms
&systemswith2ormorehomes
CommercialAuthorizationtoConstruct(AC)alsoappliestoresidentialover6
bedrooms&systemswith2ormorehomes
CommercialIP/ACalsoappliestoresidentialover6bedrooms&systemswith2or
morehomes
RVPermitOnly0120Gallonsperday
AdditiontoSystem(PerBedroom)0120GallonsperdayIP/AC/RV
RelocateTank
ConsultativeVisit
MobileHomeReconnectSiteVisit
AdditionstoStructure
ReturnVisitFee
ResidentialRepairPermit
CommercialRepairPermit

1,000.00
1,000.00

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

1.65pergal
1.65pergal
1.65pergal
250.00
250.00
225.00
125.00
125.00
125.00
125.00
0.00
.42pergal

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

Modifier

Code

Description

Fees Beginning
July 2016

30%
standard
fee

***EngineerOptionPermit(EOP)feeis30%ofstandardfee
PrivateDrinkingWaterWells(PDWW)
PrivateDrinkingWaterWell(PDWW)Permit
ConsultativeVisit
ReturnSiteVisit

375.00
125.00
125.00

AbandonmentofaWell(nochargeifdoneinconjunctionwithaPDWWPermit)
RenewalofPermitbeforeExpiration(nochangesinpermit)
WellRepair

0.00
175.00
0.00

WaterTestFees/Sampling
Allfeesincludea$5chargeforhandlingandprocessingofspecimens(dataentry,
packaging,tracking,couriercostsandexplanation/interpretationoftestresults).
FullPanelInorganicChemistryandMicrobiology
NewPrivateWaterWell
ExistingPrivateWaterWell
Microbiology
InorganicChemistryandMicrobiology
NewPrivateWaterWell
ExistingPrivateWaterWell
InorganicChemistryandMicrobiology
NewPrivateWaterWell
ExistingPrivateWaterWell
InorganicChemistryandMicrobiology
NewPrivateWaterWell

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

79.00
79.00
20.00
30.00
31.00
50.00
34.00
35.00
45.00
34.00

Macon County Public Health Fee Schedule

Modifier

Code

Description

ExistingPrivateWaterWell
InorganicChemistry
InorganicPanel(Metals,Anions,Nitrate/Nitrite)
InorganicPanel(Metals,Anions)
InorganicPanel(CoalAshTesting)
HexavalentChromium
MetalsPanel
IndividualMetals(13maximumfromabove+Uranium)
Leadfollowuptesting(upto3samplesfromsamelocation)
Anions(Fluoride,Chloride,Sulfate)
DisinfectionByProducts(Bromide,Bromate,Chlorite,Chlorate)
FluoridePhysician,Dentistrequest
Nitrate/Nitrite
Arsenicspeciation
OrganicChemistry
Pesticides
ChlorinatedPesticides
NitrogenPhosphorusPesticides
EDB,DBCPandTCP
Herbicides
Glyphosate
ChlorinatedAcidHerbicides
Carbamates
SyntheticOrganicChemicals(SOC)Scan
Petroleumproducts
VolatileOrganicChemicals(SamplecollectionmustbeperformedbyaRegistered
EHSpecialist.
FOODANDLODGING

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

30.00
73.00
68.00
73.00
57.00
64.00
50.00
70.00
34.00
34.00
34.00
31.00
34.00

79.00
79.00
79.00
79.00
79.00
79.00
79.00
79.00
129.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______

Macon County Public Health Fee Schedule

Modifier

Code

Description

FoodServiceEstablishmentPlanReviewNew/<24seats
FoodServiceEstablishmentPlanReviewExisting/<24seats
FoodServiceEstablishmentPlanReviewNew/>25seats
FoodServiceEstablishmentPlanReviewExisting/>25seats
FoodStandPlanReview
TemporaryFoodEstablishmentPermit
TattooParlorPlanReviewNew
TattooParlorPlanReviewExisting
TattooParlorPlanReviewOwner/Operator(annually)
TattooParlorPermitEachAdditionalArtist(annually)
PoolPlanReview
PoolApplicationFee(annually)
AdditionalPoolorSpa
ANIMALSERVICES
Microchippingforgeneralpublic
AdoptionCat
AdoptionDog
AdoptionSpecial
ReclaimFee
CitationOption1(atofficer'sdiscretion)
CitationOption2(atofficer'sdiscretion)
PetCarrier
QuarantineFee(perday)
SponsorFee

ProposedFees:
Reddenotesafeeincrease
Bluedenotesafeereduction
Blackdenotesnewfee

Fees Beginning
July 2016

200.00
150.00
200.00
200.00
100.00
75.00perevent
200.00
150.00
700.00
500.00
200.00
100.00
50.00
15.00
65.00
65.00
45.00
25.00
25.00
50.00
5.00
10.00
65.00

Proposed Proposed
Proposed
Fee
Fee
Change
Change FeeChange
Approved Approved Approved
by BOH
by BOH
byBOCC
8/23/16
9/27/16
______