"hospital_Austin Behavioral Hospital, LLC" last_updated_ 2023-12-31 version_1 "hospital_Austin, Texas" hospital_address 8402 Cross Park Drive license_ 100290| TX "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded in this machine-readable file is true, accurate, and complete as of the date indicated in this file" description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AARP MEDICARE COMPLETE|MANAGED MEDICARE] standard_charge|[payer_AARP MEDICARE COMPLETE|MANAGED MEDICARE] |percent standard_charge|[payer_AARP MEDICARE COMPLETE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AARP MEDICARE COMPLETE|MANAGED MEDICARE] standard_charge|[payer_AETNA|HMO/PPO] standard_charge|[payer_AETNA|HMO/PPO] |percent standard_charge|[payer_AETNA|HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA|HMO/PPO] standard_charge|[payer_AETNA BETTER HEALTH OF TX|MANAGED MEDICAID] standard_charge|[payer_AETNA BETTER HEALTH OF TX|MANAGED MEDICAID] |percent standard_charge|[payer_AETNA BETTER HEALTH OF TX|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AETNA BETTER HEALTH OF TX|MANAGED MEDICAID] standard_charge|[payer_AETNA MEDICARE|MANAGED MEDICARE] standard_charge|[payer_AETNA MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_AETNA MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA MEDICARE|MANAGED MEDICARE] standard_charge|[payer_ALL SAVERS|HMO/PPO] standard_charge|[payer_ALL SAVERS|HMO/PPO] |percent standard_charge|[payer_ALL SAVERS|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALL SAVERS|HMO/PPO] standard_charge|[payer_AMBETTER INSURANCE|HMO/PPO] standard_charge|[payer_AMBETTER INSURANCE|HMO/PPO] |percent standard_charge|[payer_AMBETTER INSURANCE|HMO/PPO] |contracting_method additional_payer_notes |[payer_AMBETTER INSURANCE|HMO/PPO] standard_charge|[payer_AMERIVANTAGE|MANAGED MEDICARE] standard_charge|[payer_AMERIVANTAGE|MANAGED MEDICARE] |percent standard_charge|[payer_AMERIVANTAGE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AMERIVANTAGE|MANAGED MEDICARE] standard_charge|[payer_ANDREWS CENTER|LOCAL GOVT] standard_charge|[payer_ANDREWS CENTER|LOCAL GOVT] |percent standard_charge|[payer_ANDREWS CENTER|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ANDREWS CENTER|LOCAL GOVT] standard_charge|[payer_ANTHEM BCBS|BLUE CROSS] standard_charge|[payer_ANTHEM BCBS|BLUE CROSS] |percent standard_charge|[payer_ANTHEM BCBS|BLUE CROSS] |contracting_method additional_payer_notes |[payer_ANTHEM BCBS|BLUE CROSS] standard_charge|[payer_APWU HEALTH PLAN|HMO/PPO] standard_charge|[payer_APWU HEALTH PLAN|HMO/PPO] |percent standard_charge|[payer_APWU HEALTH PLAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_APWU HEALTH PLAN|HMO/PPO] standard_charge|[payer_ASCENSION COMPLETE|MANAGED MEDICARE] standard_charge|[payer_ASCENSION COMPLETE|MANAGED MEDICARE] |percent standard_charge|[payer_ASCENSION COMPLETE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_ASCENSION COMPLETE|MANAGED MEDICARE] standard_charge|[payer_ATCIC PSYCH|LOCAL GOVT] standard_charge|[payer_ATCIC PSYCH|LOCAL GOVT] |percent standard_charge|[payer_ATCIC PSYCH|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ATCIC PSYCH|LOCAL GOVT] standard_charge|[payer_BAS HEALTHCOMP|HMO/PPO] standard_charge|[payer_BAS HEALTHCOMP|HMO/PPO] |percent standard_charge|[payer_BAS HEALTHCOMP|HMO/PPO] |contracting_method additional_payer_notes |[payer_BAS HEALTHCOMP|HMO/PPO] standard_charge|[payer_BCBS FEDERAL|BLUE CROSS] standard_charge|[payer_BCBS FEDERAL|BLUE CROSS] |percent standard_charge|[payer_BCBS FEDERAL|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS FEDERAL|BLUE CROSS] standard_charge|[payer_BCBS MCAID MAGELLAN|MANAGED MEDICAID] standard_charge|[payer_BCBS MCAID MAGELLAN|MANAGED MEDICAID] |percent standard_charge|[payer_BCBS MCAID MAGELLAN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BCBS MCAID MAGELLAN|MANAGED MEDICAID] standard_charge|[payer_BCBS MEDICARE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_BCBS MEDICARE ADVANTAGE|MANAGED MEDICARE] |percent standard_charge|[payer_BCBS MEDICARE ADVANTAGE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BCBS MEDICARE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_BCBS OOS ADVANTAGE HMO|BLUE CROSS] standard_charge|[payer_BCBS OOS ADVANTAGE HMO|BLUE CROSS] |percent standard_charge|[payer_BCBS OOS ADVANTAGE HMO|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OOS ADVANTAGE HMO|BLUE CROSS] standard_charge|[payer_BCBS OOS HMO|BLUE CROSS] standard_charge|[payer_BCBS OOS HMO|BLUE CROSS] |percent standard_charge|[payer_BCBS OOS HMO|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OOS HMO|BLUE CROSS] standard_charge|[payer_BCBS OOS PPO|BLUE CROSS] standard_charge|[payer_BCBS OOS PPO|BLUE CROSS] |percent standard_charge|[payer_BCBS OOS PPO|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OOS PPO|BLUE CROSS] standard_charge|[payer_BCBS TEXAS ADVANTAGE HMO|BLUE CROSS] standard_charge|[payer_BCBS TEXAS ADVANTAGE HMO|BLUE CROSS] |percent standard_charge|[payer_BCBS TEXAS ADVANTAGE HMO|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS TEXAS ADVANTAGE HMO|BLUE CROSS] standard_charge|[payer_BCBS TEXAS HMO|BLUE CROSS] standard_charge|[payer_BCBS TEXAS HMO|BLUE CROSS] |percent standard_charge|[payer_BCBS TEXAS HMO|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS TEXAS HMO|BLUE CROSS] standard_charge|[payer_BCBS TEXAS PPO|BLUE CROSS] standard_charge|[payer_BCBS TEXAS PPO|BLUE CROSS] |percent standard_charge|[payer_BCBS TEXAS PPO|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS TEXAS PPO|BLUE CROSS] standard_charge|[payer_BCBS VA MEDICAID|MANAGED MEDICAID] standard_charge|[payer_BCBS VA MEDICAID|MANAGED MEDICAID] |percent standard_charge|[payer_BCBS VA MEDICAID|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BCBS VA MEDICAID|MANAGED MEDICAID] standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] |percent standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] |contracting_method additional_payer_notes |[payer_BEACON HEALTH OPTIONS|HMO/PPO] standard_charge|[payer_BEACON HEALTH STRATEGIES|HMO/PPO] standard_charge|[payer_BEACON HEALTH STRATEGIES|HMO/PPO] |percent standard_charge|[payer_BEACON HEALTH STRATEGIES|HMO/PPO] |contracting_method additional_payer_notes |[payer_BEACON HEALTH STRATEGIES|HMO/PPO] standard_charge|[payer_BEACON HEALTH STRATEGIES|MANAGED MEDICAID] standard_charge|[payer_BEACON HEALTH STRATEGIES|MANAGED MEDICAID] |percent standard_charge|[payer_BEACON HEALTH STRATEGIES|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BEACON HEALTH STRATEGIES|MANAGED MEDICAID] standard_charge|[payer_BIND BENEFITS INC|HMO/PPO] standard_charge|[payer_BIND BENEFITS INC|HMO/PPO] |percent standard_charge|[payer_BIND BENEFITS INC|HMO/PPO] |contracting_method additional_payer_notes |[payer_BIND BENEFITS INC|HMO/PPO] standard_charge|[payer_BLUEBONNET TRAILS|LOCAL GOVT] standard_charge|[payer_BLUEBONNET TRAILS|LOCAL GOVT] |percent standard_charge|[payer_BLUEBONNET TRAILS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_BLUEBONNET TRAILS|LOCAL GOVT] standard_charge|[payer_BOON CHAPMAN|HMO/PPO] standard_charge|[payer_BOON CHAPMAN|HMO/PPO] |percent standard_charge|[payer_BOON CHAPMAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_BOON CHAPMAN|HMO/PPO] standard_charge|[payer_BRAZOS VALLEY MHMR|LOCAL GOVT] standard_charge|[payer_BRAZOS VALLEY MHMR|LOCAL GOVT] |percent standard_charge|[payer_BRAZOS VALLEY MHMR|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_BRAZOS VALLEY MHMR|LOCAL GOVT] standard_charge|[payer_BRIGHT HEALTHCARE|HMO/PPO] standard_charge|[payer_BRIGHT HEALTHCARE|HMO/PPO] |percent standard_charge|[payer_BRIGHT HEALTHCARE|HMO/PPO] |contracting_method additional_payer_notes |[payer_BRIGHT HEALTHCARE|HMO/PPO] standard_charge|[payer_CARE IMPROVEMENT|MANAGED MEDICARE] standard_charge|[payer_CARE IMPROVEMENT|MANAGED MEDICARE] |percent standard_charge|[payer_CARE IMPROVEMENT|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CARE IMPROVEMENT|MANAGED MEDICARE] standard_charge|[payer_CARELON BEHAVIORAL HE|MANAGED MEDICARE] standard_charge|[payer_CARELON BEHAVIORAL HE|MANAGED MEDICARE] |percent standard_charge|[payer_CARELON BEHAVIORAL HE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CARELON BEHAVIORAL HE|MANAGED MEDICARE] standard_charge|[payer_CENTER FOR LIFE RESOURCES|LOCAL GOVT] standard_charge|[payer_CENTER FOR LIFE RESOURCES|LOCAL GOVT] |percent standard_charge|[payer_CENTER FOR LIFE RESOURCES|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_CENTER FOR LIFE RESOURCES|LOCAL GOVT] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |percent standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CIGNA BEHAVIORAL|HMO/PPO] standard_charge|[payer_CIGNA BEHAVIORAL|HMO/PPO] |percent standard_charge|[payer_CIGNA BEHAVIORAL|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA BEHAVIORAL|HMO/PPO] standard_charge|[payer_CIGNA GREATWEST|HMO/PPO] standard_charge|[payer_CIGNA GREATWEST|HMO/PPO] |percent standard_charge|[payer_CIGNA GREATWEST|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA GREATWEST|HMO/PPO] standard_charge|[payer_CIGNA HEALTHSPRINGS|MANAGED MEDICARE] standard_charge|[payer_CIGNA HEALTHSPRINGS|MANAGED MEDICARE] |percent standard_charge|[payer_CIGNA HEALTHSPRINGS|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CIGNA HEALTHSPRINGS|MANAGED MEDICARE] standard_charge|[payer_CLOVER HEALTH|MANAGED MEDICARE] standard_charge|[payer_CLOVER HEALTH|MANAGED MEDICARE] |percent standard_charge|[payer_CLOVER HEALTH|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CLOVER HEALTH|MANAGED MEDICARE] standard_charge|[payer_COMMUNITY FIRST HEALTH|MANAGED MEDICAID] standard_charge|[payer_COMMUNITY FIRST HEALTH|MANAGED MEDICAID] |percent standard_charge|[payer_COMMUNITY FIRST HEALTH|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_COMMUNITY FIRST HEALTH|MANAGED MEDICAID] standard_charge|[payer_COMMUNITY FIRST HEALTH PL|MANAGED MEDICAID] standard_charge|[payer_COMMUNITY FIRST HEALTH PL|MANAGED MEDICAID] |percent standard_charge|[payer_COMMUNITY FIRST HEALTH PL|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_COMMUNITY FIRST HEALTH PL|MANAGED MEDICAID] standard_charge|[payer_COMMUNITY HEALTH CHOICE|MANAGED MEDICAID] standard_charge|[payer_COMMUNITY HEALTH CHOICE|MANAGED MEDICAID] |percent standard_charge|[payer_COMMUNITY HEALTH CHOICE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_COMMUNITY HEALTH CHOICE|MANAGED MEDICAID] standard_charge|[payer_COMPSYCH|HMO/PPO] standard_charge|[payer_COMPSYCH|HMO/PPO] |percent standard_charge|[payer_COMPSYCH|HMO/PPO] |contracting_method additional_payer_notes |[payer_COMPSYCH|HMO/PPO] standard_charge|[payer_CRIME VICTIMS|LOCAL GOVT] standard_charge|[payer_CRIME VICTIMS|LOCAL GOVT] |percent standard_charge|[payer_CRIME VICTIMS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_CRIME VICTIMS|LOCAL GOVT] standard_charge|[payer_DELL CHILDRENS MAGELLAN|MANAGED MEDICAID] standard_charge|[payer_DELL CHILDRENS MAGELLAN|MANAGED MEDICAID] |percent standard_charge|[payer_DELL CHILDRENS MAGELLAN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_DELL CHILDRENS MAGELLAN|MANAGED MEDICAID] standard_charge|[payer_DFPS|LOCAL GOVT] standard_charge|[payer_DFPS|LOCAL GOVT] |percent standard_charge|[payer_DFPS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_DFPS|LOCAL GOVT] standard_charge|[payer_DRISCOLL HEALTH PLAN|MANAGED MEDICAID] standard_charge|[payer_DRISCOLL HEALTH PLAN|MANAGED MEDICAID] |percent standard_charge|[payer_DRISCOLL HEALTH PLAN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_DRISCOLL HEALTH PLAN|MANAGED MEDICAID] standard_charge|[payer_EMBLEM HEALTH|MANAGED MEDICARE] standard_charge|[payer_EMBLEM HEALTH|MANAGED MEDICARE] |percent standard_charge|[payer_EMBLEM HEALTH|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_EMBLEM HEALTH|MANAGED MEDICARE] standard_charge|[payer_FIRST CARE STAR|MANAGED MEDICAID] standard_charge|[payer_FIRST CARE STAR|MANAGED MEDICAID] |percent standard_charge|[payer_FIRST CARE STAR|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_FIRST CARE STAR|MANAGED MEDICAID] standard_charge|[payer_FOUNDATION COMMUNITIES|LOCAL GOVT] standard_charge|[payer_FOUNDATION COMMUNITIES|LOCAL GOVT] |percent standard_charge|[payer_FOUNDATION COMMUNITIES|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_FOUNDATION COMMUNITIES|LOCAL GOVT] standard_charge|[payer_FRIDAY HEALTH PLANS|HMO/PPO] standard_charge|[payer_FRIDAY HEALTH PLANS|HMO/PPO] |percent standard_charge|[payer_FRIDAY HEALTH PLANS|HMO/PPO] |contracting_method additional_payer_notes |[payer_FRIDAY HEALTH PLANS|HMO/PPO] standard_charge|[payer_FRINGE BENEFIT GROUP|HMO/PPO] standard_charge|[payer_FRINGE BENEFIT GROUP|HMO/PPO] |percent standard_charge|[payer_FRINGE BENEFIT GROUP|HMO/PPO] |contracting_method additional_payer_notes |[payer_FRINGE BENEFIT GROUP|HMO/PPO] standard_charge|[payer_GULF BEND MHMR CENTER|LOCAL GOVT] standard_charge|[payer_GULF BEND MHMR CENTER|LOCAL GOVT] |percent standard_charge|[payer_GULF BEND MHMR CENTER|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_GULF BEND MHMR CENTER|LOCAL GOVT] standard_charge|[payer_HALCYON|HMO/PPO] standard_charge|[payer_HALCYON|HMO/PPO] |percent standard_charge|[payer_HALCYON|HMO/PPO] |contracting_method additional_payer_notes |[payer_HALCYON|HMO/PPO] standard_charge|[payer_HEALTH PLAN OF NEVADA|HMO/PPO] standard_charge|[payer_HEALTH PLAN OF NEVADA|HMO/PPO] |percent standard_charge|[payer_HEALTH PLAN OF NEVADA|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTH PLAN OF NEVADA|HMO/PPO] standard_charge|[payer_HEALTHPARTNERS|HMO/PPO] standard_charge|[payer_HEALTHPARTNERS|HMO/PPO] |percent standard_charge|[payer_HEALTHPARTNERS|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTHPARTNERS|HMO/PPO] standard_charge|[payer_HEALTHSELECT OF TEXAS|BLUE CROSS] standard_charge|[payer_HEALTHSELECT OF TEXAS|BLUE CROSS] |percent standard_charge|[payer_HEALTHSELECT OF TEXAS|BLUE CROSS] |contracting_method additional_payer_notes |[payer_HEALTHSELECT OF TEXAS|BLUE CROSS] standard_charge|[payer_HEALTHSMART PHYS & ANC|HMO/PPO] standard_charge|[payer_HEALTHSMART PHYS & ANC|HMO/PPO] |percent standard_charge|[payer_HEALTHSMART PHYS & ANC|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTHSMART PHYS & ANC|HMO/PPO] standard_charge|[payer_HILL COUNTRY MH|LOCAL GOVT] standard_charge|[payer_HILL COUNTRY MH|LOCAL GOVT] |percent standard_charge|[payer_HILL COUNTRY MH|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_HILL COUNTRY MH|LOCAL GOVT] standard_charge|[payer_HUMANA|HMO/PPO] standard_charge|[payer_HUMANA|HMO/PPO] |percent standard_charge|[payer_HUMANA|HMO/PPO] |contracting_method additional_payer_notes |[payer_HUMANA|HMO/PPO] standard_charge|[payer_HUMANA GOLD CHOICE|MANAGED MEDICARE] standard_charge|[payer_HUMANA GOLD CHOICE|MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA GOLD CHOICE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA GOLD CHOICE|MANAGED MEDICARE] standard_charge|[payer_ICE HEALTH SERVICES CORPS|LOCAL GOVT] standard_charge|[payer_ICE HEALTH SERVICES CORPS|LOCAL GOVT] |percent standard_charge|[payer_ICE HEALTH SERVICES CORPS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ICE HEALTH SERVICES CORPS|LOCAL GOVT] standard_charge|[payer_IMPERIAL INSURANCE CO|MANAGED MEDICARE] standard_charge|[payer_IMPERIAL INSURANCE CO|MANAGED MEDICARE] |percent standard_charge|[payer_IMPERIAL INSURANCE CO|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_IMPERIAL INSURANCE CO|MANAGED MEDICARE] standard_charge|[payer_INSURANCE BENEFIT ADMIN|HMO/PPO] standard_charge|[payer_INSURANCE BENEFIT ADMIN|HMO/PPO] |percent standard_charge|[payer_INSURANCE BENEFIT ADMIN|HMO/PPO] |contracting_method additional_payer_notes |[payer_INSURANCE BENEFIT ADMIN|HMO/PPO] standard_charge|[payer_MAGELLAN|HMO/PPO] standard_charge|[payer_MAGELLAN|HMO/PPO] |percent standard_charge|[payer_MAGELLAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_MAGELLAN|HMO/PPO] standard_charge|[payer_MEDICARE|MEDICARE] standard_charge|[payer_MEDICARE|MEDICARE] |percent standard_charge|[payer_MEDICARE|MEDICARE] |contracting_method additional_payer_notes |[payer_MEDICARE|MEDICARE] standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] |percent standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_MERITAIN HEALTH|HMO/PPO] standard_charge|[payer_MOLINA EXCHANGE|HMO/PPO] standard_charge|[payer_MOLINA EXCHANGE|HMO/PPO] |percent standard_charge|[payer_MOLINA EXCHANGE|HMO/PPO] |contracting_method additional_payer_notes |[payer_MOLINA EXCHANGE|HMO/PPO] standard_charge|[payer_MOLINA HEALTHCARE|MANAGED MEDICAID] standard_charge|[payer_MOLINA HEALTHCARE|MANAGED MEDICAID] |percent standard_charge|[payer_MOLINA HEALTHCARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MOLINA HEALTHCARE|MANAGED MEDICAID] standard_charge|[payer_NINETY DEGREE BENEFITS|HMO/PPO] standard_charge|[payer_NINETY DEGREE BENEFITS|HMO/PPO] |percent standard_charge|[payer_NINETY DEGREE BENEFITS|HMO/PPO] |contracting_method additional_payer_notes |[payer_NINETY DEGREE BENEFITS|HMO/PPO] standard_charge|[payer_OPTUM|HMO/PPO] standard_charge|[payer_OPTUM|HMO/PPO] |percent standard_charge|[payer_OPTUM|HMO/PPO] |contracting_method additional_payer_notes |[payer_OPTUM|HMO/PPO] standard_charge|[payer_OPTUM MEDICARE|MANAGED MEDICARE] standard_charge|[payer_OPTUM MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_OPTUM MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_OPTUM MEDICARE|MANAGED MEDICARE] standard_charge|[payer_PENDING MEDICAID|MEDICAID ] standard_charge|[payer_PENDING MEDICAID|MEDICAID ] |percent standard_charge|[payer_PENDING MEDICAID|MEDICAID ] |contracting_method additional_payer_notes |[payer_PENDING MEDICAID|MEDICAID ] standard_charge|[payer_PHYSICIANS HEALTH CHOICE|MANAGED MEDICARE] standard_charge|[payer_PHYSICIANS HEALTH CHOICE|MANAGED MEDICARE] |percent standard_charge|[payer_PHYSICIANS HEALTH CHOICE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_PHYSICIANS HEALTH CHOICE|MANAGED MEDICARE] standard_charge|[payer_RIGHTCARE SCOTT AND WHITE|MANAGED MEDICAID] standard_charge|[payer_RIGHTCARE SCOTT AND WHITE|MANAGED MEDICAID] |percent standard_charge|[payer_RIGHTCARE SCOTT AND WHITE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_RIGHTCARE SCOTT AND WHITE|MANAGED MEDICAID] standard_charge|[payer_SAMSO ATCIC|LOCAL GOVT] standard_charge|[payer_SAMSO ATCIC|LOCAL GOVT] |percent standard_charge|[payer_SAMSO ATCIC|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_SAMSO ATCIC|LOCAL GOVT] standard_charge|[payer_SANA BENEFITS|HMO/PPO] standard_charge|[payer_SANA BENEFITS|HMO/PPO] |percent standard_charge|[payer_SANA BENEFITS|HMO/PPO] |contracting_method additional_payer_notes |[payer_SANA BENEFITS|HMO/PPO] standard_charge|[payer_SCOTT AND WHITE HEALTH|COMMERCIAL] standard_charge|[payer_SCOTT AND WHITE HEALTH|COMMERCIAL] |percent standard_charge|[payer_SCOTT AND WHITE HEALTH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_SCOTT AND WHITE HEALTH|COMMERCIAL] standard_charge|[payer_SCOTT AND WHITE HEALTH|HMO/PPO] standard_charge|[payer_SCOTT AND WHITE HEALTH|HMO/PPO] |percent standard_charge|[payer_SCOTT AND WHITE HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_SCOTT AND WHITE HEALTH|HMO/PPO] standard_charge|[payer_SCOTT AND WHITE MKTPLACE|HMO/PPO] standard_charge|[payer_SCOTT AND WHITE MKTPLACE|HMO/PPO] |percent standard_charge|[payer_SCOTT AND WHITE MKTPLACE|HMO/PPO] |contracting_method additional_payer_notes |[payer_SCOTT AND WHITE MKTPLACE|HMO/PPO] standard_charge|[payer_SCOTT AND WHITE PREFERRED|HMO/PPO] standard_charge|[payer_SCOTT AND WHITE PREFERRED|HMO/PPO] |percent standard_charge|[payer_SCOTT AND WHITE PREFERRED|HMO/PPO] |contracting_method additional_payer_notes |[payer_SCOTT AND WHITE PREFERRED|HMO/PPO] standard_charge|[payer_SENDERO HEALTH|MANAGED MEDICAID] standard_charge|[payer_SENDERO HEALTH|MANAGED MEDICAID] |percent standard_charge|[payer_SENDERO HEALTH|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SENDERO HEALTH|MANAGED MEDICAID] standard_charge|[payer_SENDERO IDEALCARE|HMO/PPO] standard_charge|[payer_SENDERO IDEALCARE|HMO/PPO] |percent standard_charge|[payer_SENDERO IDEALCARE|HMO/PPO] |contracting_method additional_payer_notes |[payer_SENDERO IDEALCARE|HMO/PPO] standard_charge|[payer_SENIOR CARE|MANAGED MEDICARE] standard_charge|[payer_SENIOR CARE|MANAGED MEDICARE] |percent standard_charge|[payer_SENIOR CARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_SENIOR CARE|MANAGED MEDICARE] standard_charge|[payer_SIMS FOUNDATION|HMO/PPO] standard_charge|[payer_SIMS FOUNDATION|HMO/PPO] |percent standard_charge|[payer_SIMS FOUNDATION|HMO/PPO] |contracting_method additional_payer_notes |[payer_SIMS FOUNDATION|HMO/PPO] standard_charge|[payer_STAR BCBS MCAID MAG UHRIP|MANAGED MEDICAID] standard_charge|[payer_STAR BCBS MCAID MAG UHRIP|MANAGED MEDICAID] |percent standard_charge|[payer_STAR BCBS MCAID MAG UHRIP|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_STAR BCBS MCAID MAG UHRIP|MANAGED MEDICAID] standard_charge|[payer_STAR DELL CHILDRENS UHRIP|MANAGED MEDICAID] standard_charge|[payer_STAR DELL CHILDRENS UHRIP|MANAGED MEDICAID] |percent standard_charge|[payer_STAR DELL CHILDRENS UHRIP|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_STAR DELL CHILDRENS UHRIP|MANAGED MEDICAID] standard_charge|[payer_STAR SUPERIOR UHRIP|MANAGED MEDICAID] standard_charge|[payer_STAR SUPERIOR UHRIP|MANAGED MEDICAID] |percent standard_charge|[payer_STAR SUPERIOR UHRIP|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_STAR SUPERIOR UHRIP|MANAGED MEDICAID] standard_charge|[payer_STAR UHC COMM STAR PLUS|MANAGED MEDICAID] standard_charge|[payer_STAR UHC COMM STAR PLUS|MANAGED MEDICAID] |percent standard_charge|[payer_STAR UHC COMM STAR PLUS|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_STAR UHC COMM STAR PLUS|MANAGED MEDICAID] standard_charge|[payer_STAR DRISCOLL CHIRP] standard_charge|[payer_STAR DRISCOLL CHIRP] |percent standard_charge|[payer_STAR DRISCOLL CHIRP] |contracting_method additional_payer_notes |[payer_STAR DRISCOLL CHIRP] standard_charge|[payer_STAR RIGHTCARE S&W CHIRP] standard_charge|[payer_STAR RIGHTCARE S&W CHIRP] |percent standard_charge|[payer_STAR RIGHTCARE S&W CHIRP] |contracting_method additional_payer_notes |[payer_STAR RIGHTCARE S&W CHIRP] standard_charge|[payer_SUPERIOR HEALTHPLAN|MANAGED MEDICAID] standard_charge|[payer_SUPERIOR HEALTHPLAN|MANAGED MEDICAID] |percent standard_charge|[payer_SUPERIOR HEALTHPLAN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SUPERIOR HEALTHPLAN|MANAGED MEDICAID] standard_charge|[payer_SUPERIOR MEDICARE|MANAGED MEDICARE] standard_charge|[payer_SUPERIOR MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_SUPERIOR MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_SUPERIOR MEDICARE|MANAGED MEDICARE] standard_charge|[payer_SUREST|HMO/PPO] standard_charge|[payer_SUREST|HMO/PPO] |percent standard_charge|[payer_SUREST|HMO/PPO] |contracting_method additional_payer_notes |[payer_SUREST|HMO/PPO] standard_charge|[payer_TEXAS CHILDREN|MANAGED MEDICAID] standard_charge|[payer_TEXAS CHILDREN|MANAGED MEDICAID] |percent standard_charge|[payer_TEXAS CHILDREN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_TEXAS CHILDREN|MANAGED MEDICAID] standard_charge|[payer_TEXAS INDEPENDENCE HEALTH|MANAGED MEDICARE] standard_charge|[payer_TEXAS INDEPENDENCE HEALTH|MANAGED MEDICARE] |percent standard_charge|[payer_TEXAS INDEPENDENCE HEALTH|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_TEXAS INDEPENDENCE HEALTH|MANAGED MEDICARE] standard_charge|[payer_TEXAS MUTUAL INSURANCE|WORKERS COMP] standard_charge|[payer_TEXAS MUTUAL INSURANCE|WORKERS COMP] |percent standard_charge|[payer_TEXAS MUTUAL INSURANCE|WORKERS COMP] |contracting_method additional_payer_notes |[payer_TEXAS MUTUAL INSURANCE|WORKERS COMP] standard_charge|[payer_TEXOMA COMMUNITY CENTER|LOCAL GOVT] standard_charge|[payer_TEXOMA COMMUNITY CENTER|LOCAL GOVT] |percent standard_charge|[payer_TEXOMA COMMUNITY CENTER|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TEXOMA COMMUNITY CENTER|LOCAL GOVT] standard_charge|[payer_TMHP|MEDICAID ] standard_charge|[payer_TMHP|MEDICAID ] |percent standard_charge|[payer_TMHP|MEDICAID ] |contracting_method additional_payer_notes |[payer_TMHP|MEDICAID ] standard_charge|[payer_TML MULTISTATE|HMO/PPO] standard_charge|[payer_TML MULTISTATE|HMO/PPO] |percent standard_charge|[payer_TML MULTISTATE|HMO/PPO] |contracting_method additional_payer_notes |[payer_TML MULTISTATE|HMO/PPO] standard_charge|[payer_TRICARE|TRICARE] standard_charge|[payer_TRICARE|TRICARE] |percent standard_charge|[payer_TRICARE|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE|TRICARE] standard_charge|[payer_TRICARE FOR LIFE|TRICARE] standard_charge|[payer_TRICARE FOR LIFE|TRICARE] |percent standard_charge|[payer_TRICARE FOR LIFE|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE FOR LIFE|TRICARE] standard_charge|[payer_TRICARE PRIME RETIRED|TRICARE] standard_charge|[payer_TRICARE PRIME RETIRED|TRICARE] |percent standard_charge|[payer_TRICARE PRIME RETIRED|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE PRIME RETIRED|TRICARE] standard_charge|[payer_TRICARE WEST|TRICARE] standard_charge|[payer_TRICARE WEST|TRICARE] |percent standard_charge|[payer_TRICARE WEST|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE WEST|TRICARE] standard_charge|[payer_TRIWEST|TRICARE] standard_charge|[payer_TRIWEST|TRICARE] |percent standard_charge|[payer_TRIWEST|TRICARE] |contracting_method additional_payer_notes |[payer_TRIWEST|TRICARE] standard_charge|[payer_TRIWEST VA CCN|VETERANS ADMIN] standard_charge|[payer_TRIWEST VA CCN|VETERANS ADMIN] |percent standard_charge|[payer_TRIWEST VA CCN|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_TRIWEST VA CCN|VETERANS ADMIN] standard_charge|[payer_TRS SCOTT AND WHITE|HMO/PPO] standard_charge|[payer_TRS SCOTT AND WHITE|HMO/PPO] |percent standard_charge|[payer_TRS SCOTT AND WHITE|HMO/PPO] |contracting_method additional_payer_notes |[payer_TRS SCOTT AND WHITE|HMO/PPO] standard_charge|[payer_UBH|HMO/PPO] standard_charge|[payer_UBH|HMO/PPO] |percent standard_charge|[payer_UBH|HMO/PPO] |contracting_method additional_payer_notes |[payer_UBH|HMO/PPO] standard_charge|[payer_UCS BENVEO MULTIPLAN|HMO/PPO] standard_charge|[payer_UCS BENVEO MULTIPLAN|HMO/PPO] |percent standard_charge|[payer_UCS BENVEO MULTIPLAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_UCS BENVEO MULTIPLAN|HMO/PPO] standard_charge|[payer_UHC COMM STAR PLUS|MANAGED MEDICAID] standard_charge|[payer_UHC COMM STAR PLUS|MANAGED MEDICAID] |percent standard_charge|[payer_UHC COMM STAR PLUS|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_UHC COMM STAR PLUS|MANAGED MEDICAID] standard_charge|[payer_UHC GOLDEN RULE|HMO/PPO] standard_charge|[payer_UHC GOLDEN RULE|HMO/PPO] |percent standard_charge|[payer_UHC GOLDEN RULE|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC GOLDEN RULE|HMO/PPO] standard_charge|[payer_UHC OPTIONS PPO|HMO/PPO] standard_charge|[payer_UHC OPTIONS PPO|HMO/PPO] |percent standard_charge|[payer_UHC OPTIONS PPO|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC OPTIONS PPO|HMO/PPO] standard_charge|[payer_UHC OXFORD|HMO/PPO] standard_charge|[payer_UHC OXFORD|HMO/PPO] |percent standard_charge|[payer_UHC OXFORD|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC OXFORD|HMO/PPO] standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO] standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO] |percent standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC SHARED SERVICES|HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURCE|HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURCE|HMO/PPO] |percent standard_charge|[payer_UHC STUDENT RESOURCE|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC STUDENT RESOURCE|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO] |percent standard_charge|[payer_UMR|HMO/PPO] |contracting_method additional_payer_notes |[payer_UMR|HMO/PPO] standard_charge|[payer_UNITED HEALTH INTEGRATED|HMO/PPO] standard_charge|[payer_UNITED HEALTH INTEGRATED|HMO/PPO] |percent standard_charge|[payer_UNITED HEALTH INTEGRATED|HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED HEALTH INTEGRATED|HMO/PPO] standard_charge|[payer_US HEALTH AND LIFE|HMO/PPO] standard_charge|[payer_US HEALTH AND LIFE|HMO/PPO] |percent standard_charge|[payer_US HEALTH AND LIFE|HMO/PPO] |contracting_method additional_payer_notes |[payer_US HEALTH AND LIFE|HMO/PPO] standard_charge|[payer_US HEALTH AND LIFE INS|HMO/PPO] standard_charge|[payer_US HEALTH AND LIFE INS|HMO/PPO] |percent standard_charge|[payer_US HEALTH AND LIFE INS|HMO/PPO] |contracting_method additional_payer_notes |[payer_US HEALTH AND LIFE INS|HMO/PPO] standard_charge|[payer_USAA|HMO/PPO] standard_charge|[payer_USAA|HMO/PPO] |percent standard_charge|[payer_USAA|HMO/PPO] |contracting_method additional_payer_notes |[payer_USAA|HMO/PPO] standard_charge|[payer_VA|VETERANS ADMIN] standard_charge|[payer_VA|VETERANS ADMIN] |percent standard_charge|[payer_VA|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_VA|VETERANS ADMIN] standard_charge|[payer_VALUE OPTIONS MEDICARE|MANAGED MEDICARE] standard_charge|[payer_VALUE OPTIONS MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_VALUE OPTIONS MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_VALUE OPTIONS MEDICARE|MANAGED MEDICARE] standard_charge|[payer_WEB TPA|HMO/PPO] standard_charge|[payer_WEB TPA|HMO/PPO] |percent standard_charge|[payer_WEB TPA|HMO/PPO] |contracting_method additional_payer_notes |[payer_WEB TPA|HMO/PPO] standard_charge|[payer_WELLCARE|MANAGED MEDICARE] standard_charge|[payer_WELLCARE|MANAGED MEDICARE] |percent standard_charge|[payer_WELLCARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_WELLCARE|MANAGED MEDICARE] standard_charge|[payer_WELLCARE BY ALLWALL|MANAGED MEDICARE] standard_charge|[payer_WELLCARE BY ALLWALL|MANAGED MEDICARE] |percent standard_charge|[payer_WELLCARE BY ALLWALL|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_WELLCARE BY ALLWALL|MANAGED MEDICARE] standard_charge|[payer_WELLCARE BY ALLWELL|MANAGED MEDICARE] standard_charge|[payer_WELLCARE BY ALLWELL|MANAGED MEDICARE] |percent standard_charge|[payer_WELLCARE BY ALLWELL|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_WELLCARE BY ALLWELL|MANAGED MEDICARE] standard_charge|[payer_WELLMED|MANAGED MEDICARE] standard_charge|[payer_WELLMED|MANAGED MEDICARE] |percent standard_charge|[payer_WELLMED|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_WELLMED|MANAGED MEDICARE] ROOM AND BOARD ACUTE PSYCH-ADOL 124 RC facility inpatient 2340.00 700 525 1651 962.02 per diem 529.59 per diem 934 per diem 743 per diem 700 per diem 700 per diem 700 per diem 700 per diem drg 700 per diem 700 per diem 805 per diem 960 per diem 757 per diem 674 per diem 753 per diem 805 per diem 595 per diem 753 per diem 805 per diem 850 per diem 790 per diem 850 per diem 743 per diem 625 per diem 700 per diem 600 per diem 700 per diem PSYCH DRG PSYCH DRG PSYCH DRG PSYCH DRG 525 per diem PSYCH DRG 900 per diem 900 per diem PSYCH DRG PSYCH DRG 529.59 per diem 529.59 per diem 950.00 per diem 600 per diem 960 per diem 650 per diem 794.39 per diem PSYCH DRG PSYCH DRG 529.59 per diem 550 per diem 700 per diem 700 per diem 660.00 per diem 700 per diem 743 per diem 700 per diem 793 per diem 840 per diem 675 per diem 1012 per diem PSYCH DRG PSYCH DRG 850 per diem 700 per diem 700 per diem 960 per diem PSYCH DRG PSYCH DRG 855 per diem 650 per diem 650 per diem 700 per diem 780 per diem PSYCH DRG PSYCH DRG 529.59 per diem PSYCH DRG PSYCH DRG 529.59 per diem 782.66 per diem 700 per diem 700.00 per diem 700.00 per diem 700 per diem 700 per diem 600 per diem 700 per diem PSYCH DRG PSYCH DRG 725 per diem "1,651.00 " per diem "1,651.00 " per diem "1,104.24 " per diem 910.89 per diem "1,366.35 " per diem 910.89 per diem 642 per diem PSYCH DRG PSYCH DRG 700 per diem 529.59 per diem PSYCH DRG PSYCH DRG 700 per diem 700 per diem 529.59 per diem 728 per diem 736.8 per diem 673.6 per diem 736.8 per diem 708 per diem 736.8 per diem 673.6 per diem 700 per diem 780 per diem 700 per diem 529.59 per diem 780.00 per diem 780 per diem 780 per diem 780 per diem 728 per diem 780 per diem 780 per diem 700 per diem 700.00 per diem 700 per diem 629 per diem PSYCH DRG PSYCH DRG 700 per diem PSYCH DRG PSYCH DRG PSYCH DRG PSYCH DRG 700 per diem ROOM AND BOARD ACUTE DETOX 126 RC facility inpatient 2340.00 700 529.59 1651 962.02 per diem 529.59 per diem 934 per diem 743 per diem 700 per diem 700 per diem 700 per diem drg 700 per diem 700 per diem 805 per diem 960 per diem 757 per diem 674 per diem 753 per diem 805 per diem 595 per diem 753 per diem 805 per diem 850 per diem 790 per diem 850 per diem 743 per diem 625 per diem 700 per diem 700 per diem PSYCH DRG PSYCH DRG PSYCH DRG PSYCH DRG 900 per diem 900 per diem 529.59 per diem 529.59 per diem 900.00 per diem 600 per diem 650 per diem 794.39 per diem PSYCH DRG PSYCH DRG 529.59 per diem 550 per diem 700 per diem 700 per diem 660.00 per diem 700 per diem 743 per diem 700 per diem 793 per diem 840 per diem 675 per diem 1012 per diem PSYCH DRG PSYCH DRG 700 per diem 700 per diem 960 per diem PSYCH DRG PSYCH DRG 855 per diem 650 per diem 650 per diem 700 per diem 780 per diem PSYCH DRG PSYCH DRG 529.59 per diem PSYCH DRG PSYCH DRG 529.59 per diem 782.66 per diem 700 per diem 700.00 per diem 700.00 per diem 700 per diem 700 per diem 600 per diem 700 per diem PSYCH DRG PSYCH DRG "1,651.00 " per diem "1,651.00 " per diem "1,104.24 " per diem 910.89 per diem "1,366.35 " per diem 910.89 per diem 642 per diem PSYCH DRG PSYCH DRG 700 per diem 529.59 per diem PSYCH DRG PSYCH DRG 700 per diem 700 per diem 529.59 per diem 728 per diem 736.8 per diem 673.6 per diem 736.8 per diem 708 per diem 736.8 per diem 673.6 per diem 700 per diem 780 per diem 700 per diem 529.59 per diem 780.00 per diem 780 per diem 780 per diem 780 per diem 728 per diem 780 per diem 780 per diem 700.00 per diem 700 per diem 629 per diem PSYCH DRG PSYCH DRG PSYCH DRG PSYCH DRG PSYCH DRG PSYCH DRG 700 per diem BRIDGE ADOLESC PSYCH 513 RC facility inpatient 85.00 20 128 drg 80 per diem 50 per diem 80 per diem 95 per diem 80 per diem 120 per diem 128.00 per diem 128.00 per diem 120.00 per diem 20 per diem 102.73 per diem 102.73 per diem 102.73 per diem 102.73 per diem 80 per diem 80 per diem 80.00 per diem 80 per diem 80 per diem BRIDGE ADULT PSYCH 513 RC facility inpatient 85.00 20 128 drg 80 per diem 50 per diem 80 per diem 95 per diem 80 per diem 120 per diem 128.00 per diem 128.00 per diem 120.00 per diem 20 per diem 102.73 per diem 102.73 per diem 102.73 per diem 102.73 per diem 80 per diem 80 per diem 80.00 per diem 80 per diem 80 per diem BRIDGE CHILD PSYCH 513 RC facility inpatient 85.00 20 128 drg 80 per diem 50 per diem 80 per diem 95 per diem 80 per diem 120 per diem 128.00 per diem 128.00 per diem 120.00 per diem 20 per diem 102.73 per diem 102.73 per diem 102.73 per diem 102.73 per diem 80 per diem 80 per diem 80.00 per diem 80 per diem 80 per diem BRIDGE DETOX ADULT 513 RC facility inpatient 85.00 20 128 drg 80 per diem 50 per diem 80 per diem 95 per diem 80 per diem 120 per diem 128.00 per diem 128.00 per diem 120.00 per diem 20 per diem 102.73 per diem 102.73 per diem 102.73 per diem 102.73 per diem 80 per diem 80 per diem 80.00 per diem 80 per diem 80 per diem INTENSIVE OUTPATIENT PROGRAM PSYCH ADULT 905 RC facility outpatient 778.00 210 106 377.5 181 per diem 224.54 per diem 218 per diem 200 per diem 165 per diem drg 240 per diem 338 per diem 216 per diem 228 per diem 240 per diem 228 per diem 240 per diem 210 per diem 377.5 per diem 208 per diem 150 per diem 275 per diem 338 per diem 152.00 per diem 181 per diem 130 per diem 210 per diem 292.00 per diem 338 per diem 150.42 per diem 210 per diem 210 per diem 125 per diem 106 per diem 150 per diem 210 per diem 210 per diem 210 per diem 152 per diem 210 per diem 210 per diem 181 per diem TH INTENSIVE OUTPATIENT PROGRAM PSYCH ADULT 905 RC facility outpatient 778.00 210 106 377.5 181 per diem 224.54 per diem 218 per diem 200 per diem 165 per diem drg 240 per diem 338 per diem 216 per diem 228 per diem 240 per diem 228 per diem 240 per diem 210 per diem 377.5 per diem 208 per diem 150 per diem 275 per diem 338 per diem 152.00 per diem 181 per diem 130 per diem 210 per diem 292.00 per diem 338 per diem 150.42 per diem 210 per diem 210 per diem 125 per diem 106 per diem 150 per diem 210 per diem 210 per diem 210 per diem 152 per diem 210 per diem 210 per diem 181 per diem INTENSIVE OUTPATIENT PROGRAM CD ADULT 906 RC facility outpatient 778.00 210 106 377.5 181 per diem 224.54 per diem 218 per diem 200 per diem 165 per diem drg 281 per diem 338 per diem 270 per diem 228 per diem 281 per diem 228 per diem 281 per diem 377.5 per diem 208 per diem 150 per diem 275 per diem 338 per diem 152.00 per diem 181 per diem 338 per diem 150.42 per diem 125 per diem 106 per diem 150 per diem 210 per diem 210 per diem 210 per diem 152 per diem 210 per diem 210 per diem 181 per diem TELEH INTENSIVE OUTPATIENT PROGRAM CD ADULT 906 RC facility outpatient 778.00 210 106 377.5 181 per diem 224.54 per diem 218 per diem 200 per diem 165 per diem drg 281 per diem 338 per diem 270 per diem 228 per diem 281 per diem 228 per diem 281 per diem 377.5 per diem 208 per diem 150 per diem 275 per diem 338 per diem 152.00 per diem 181 per diem 338 per diem 150.42 per diem 125 per diem 106 per diem 150 per diem 210 per diem 210 per diem 210 per diem 152 per diem 210 per diem 210 per diem 181 per diem PARTIAL HOSPITAL PROGRAM ADOLESCENT PYSCH 912 RC facility outpatient 1170.00 350 125 585 210 per diem 450.11 per diem 230 per diem 275 per diem 225 per diem 350 per diem drg 350 per diem 450 per diem 486 per diem 450 per diem 428 per diem 450 per diem 267 per diem 450 per diem 350 per diem 585 per diem 339 per diem 300 per diem 400 per diem 486 per diem 175.00 per diem 210 per diem 150 per diem 350 per diem 551.00 per diem 486 per diem 350 per diem 350 per diem 242 per diem 210 per diem 185 per diem 241 per diem 125 per diem 350 per diem 350 per diem 350 per diem 242 per diem 175 per diem 242 per diem 350 per diem 350 per diem 210 per diem PARTIAL HOSPITAL PROGRAM PSYCH 912 RC facility outpatient 1135.00 350 125 585 210 per diem 450.11 per diem 230 per diem 275 per diem 225 per diem 350 per diem drg 350 per diem 450 per diem 486 per diem 450 per diem 428 per diem 450 per diem 267 per diem 450 per diem 350 per diem 585 per diem 339 per diem 300 per diem 400 per diem 486 per diem 175.00 per diem 210 per diem 150 per diem 350 per diem 551.00 per diem 486 per diem 350 per diem 350 per diem 242 per diem 210 per diem 185 per diem 241 per diem 125 per diem 350 per diem 350 per diem 350 per diem 242 per diem 175 per diem 242 per diem 350 per diem 350 per diem 210 per diem TELEH PARTIAL HOSPITAL PROGRAM CD ADULTS 912 RC facility outpatient 1170.00 350 125 585 210 per diem 450.11 per diem 230 per diem 275 per diem 225 per diem 350 per diem drg 350 per diem 450 per diem 486 per diem 450 per diem 428 per diem 450 per diem 267 per diem 450 per diem 350 per diem 585 per diem 339 per diem 300 per diem 400 per diem 486 per diem 175.00 per diem 210 per diem 150 per diem 350 per diem 551.00 per diem 486 per diem 350 per diem 350 per diem 242 per diem 210 per diem 185 per diem 241 per diem 125 per diem 350 per diem 350 per diem 350 per diem 242 per diem 175 per diem 242 per diem 350 per diem 350 per diem 210 per diem TH PARTIAL HOSPITAL PROGRAM ADOLESCENTS 912 RC facility outpatient 1170.00 350 125 585 210 per diem 450.11 per diem 230 per diem 275 per diem 225 per diem 350 per diem drg 350 per diem 450 per diem 486 per diem 450 per diem 428 per diem 450 per diem 267 per diem 450 per diem 350 per diem 585 per diem 339 per diem 300 per diem 400 per diem 486 per diem 175.00 per diem 210 per diem 150 per diem 350 per diem 551.00 per diem 486 per diem 350 per diem 350 per diem 242 per diem 210 per diem 185 per diem 241 per diem 125 per diem 350 per diem 350 per diem 350 per diem 242 per diem 175 per diem 242 per diem 350 per diem 350 per diem 210 per diem TH PARTIAL HOSPITAL PROGRAM MH ADULT 912 RC facility outpatient 1170.00 350 125 585 210 per diem 450.11 per diem 230 per diem 275 per diem 225 per diem 350 per diem drg 350 per diem 450 per diem 486 per diem 450 per diem 428 per diem 450 per diem 267 per diem 450 per diem 350 per diem 585 per diem 339 per diem 300 per diem 400 per diem 486 per diem 175.00 per diem 210 per diem 150 per diem 350 per diem 551.00 per diem 486 per diem 350 per diem 350 per diem 242 per diem 210 per diem 185 per diem 241 per diem 125 per diem 350 per diem 350 per diem 350 per diem 242 per diem 175 per diem 242 per diem 350 per diem 350 per diem 210 per diem INTENSIVE OUTPATIENT PROGRAM ADOL GROUP 915 RC facility outpatient 259.33 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem INTENSIVE OUTPATIENT PROGRAM CD PROC GRP 1 915 RC facility outpatient 275.00 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem INTENSIVE OUTPATIENT PROGRAM MCR PSY PROC 3 915 RC facility outpatient 228.00 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem PARTIAL HOSPITAL PROGRAM ADOL GROUP 915 RC facility outpatient 1170.00 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem PARTIAL HOSPITAL PROGRAM CD MCR PRC GRP 1 915 RC facility outpatient 325.00 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem TH INTENSIVE OUTPATIENT PROGRAM CD PROC GP 2 915 RC facility outpatient 275.00 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem TH INTENSIVE OUTPATIENT PROGRAM MCR PSY PRC 1 915 RC facility outpatient 275.00 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem TH INTENSIVE OUTPATIENT PROGRAM PROCESS GRP 1 915 RC facility outpatient 275.00 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem TH PARTIAL HOSPITAL PROGRAM CD MRC PROC 3 915 RC facility outpatient 325.00 80 140 450 437 per diem drg 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem TH PARTIAL HOSPITAL PROGRAM MH PROC GRP 1 915 RC facility outpatient 325.00 80 140 450 437 per diem 450 per diem 228.54 per diem 140 per diem 350 per diem 350 per diem 152 per diem 90792 Initial Eval - With Medical 310.00 90792 RC facility Professional Fees 310.00 128.5 231.22 145.00 fee schedule 231.22 fee schedule 138.00 fee schedule 226.99 fee schedule 226.99 fee schedule 147.05 fee schedule 147.05 fee schedule 132.00 fee schedule 171.81 fee schedule 155.00 fee schedule 128.50 fee schedule 153.93 fee schedule 142.02 fee schedule 130.39 fee schedule 145.00 fee schedule 99231 Subseq Care (15 Min) 120.00 99231 RC facility Professional Fees 120.00 35.13 141 141.00 fee schedule 49.55 fee schedule 70.00 fee schedule 40.90 fee schedule 40.91 fee schedule 70.26 fee schedule 45.00 fee schedule 45.00 fee schedule 70.00 fee schedule 47.93 fee schedule 92.00 fee schedule 47.00 fee schedule 70.26 fee schedule 35.13 fee schedule 38.23 fee schedule 99232 Subseq Care (25 Min) 140.00 99232 RC facility Professional Fees 140.00 75.56 75.56 75.56 fee schedule 75.56 fee schedule 99238 Discharge Day Mgmt <30 Min 160.00 99238 RC facility Professional Fees 160.00 60.51 112 95.00 fee schedule 81.37 fee schedule 60.51 fee schedule 112.00 fee schedule 112.00 fee schedule 65.00 fee schedule 95.00 fee schedule 79.99 fee schedule