| Item | Description | Rate |
|---|---|---|
| 3 | Level A - Brief | $43.85 |
| 23 | Level B - Standard < 20 mins | $85.20 |
| 36 | Level C - Long 20 - 40 mins | $159.70 |
| 44 | Level D - Prolonged > 40 mins | $237.40 |
| 91891 | Standard Telehealth | $85.20 |
| 24 | Home Visit | $200.05 |
| 37 | Home Visit | $258.55 |
| Dr. Wilson Item 23 | Level B - Standard < 20 mins | $90.00 |
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