| G2022 | A model participant (ambulance supplier/provider), the beneficiary refuses services covered under the model (transport to an alternate destination/treatment in place) |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
| G0551 | Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes |
| L3520 | Orthopedic shoe addition, insole, felt covered with leather |
