Table 1.

Colorado Medicaid's 1992 Reimbursement for Otitis Media Services

Visit TypeReimbursement
Primary care, brief$12.05
Primary care, limited$21.22
Primary care, intermediate$29.37
Primary care, extended$38.73
Primary care, comprehensive$47.60
ENT/specialist, brief$26.60
ENT/specialist, limited$43.38
ENT/specialist, intermediate$49.44
ENT/specialist, extended$62.03
ENT/specialist, comprehensive$62.03
Emergency department, brief$95.87
Emergency department, limited$104.74
Emergency department, intermediate$111.27
Emergency department, extended$117.52
Emergency department, comprehensive$123.68
ProcedureReimburement
Tympanostomy with insertion of
ventilating tubes (unilateral)		$490.50
Tympanostomy with insertion of
ventilating tubes (bilateral)		$597.48
Mastoidectomy, simple$1160.91
Mastoidectomy, radical$1528.64
Tonsillectomy with adenoidectomy$530.46
Adenoidectomy without tonsillectomy$446.88
Adenoidectomy with tonsillectomy
and bilateral ventilating tubes		$778.16
Adenoidectomy with tonsillectomy
and unilateral ventilating tubes		$664.18

  • ENT indicates ear, nose, and throat.

  • * Includes a $85.51 facility fee for emergency department visits.

  • † Includes reimbursement for physician services, facility, and anesthesia.