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Specialty Provider lndlvidual and/or group (including Non-MD or DO) shall be reimbursed for anesthesiology services ln accordance with the accumulation of base, modifier and time unfts multiplled by the Washington State Medicaid Anesthesla Conversion Factor. The servlces should be billed ln minute lncrements, One tlme unit wlll be allowed for each flfteen (15) minute interval, or fractlon thereof, starting from the time Provider begins to prepare ihe Member for lnduction and ending when the Member may safely be placed under posloperative supervilion and Provider is no longer in personal aftendance. Ambulatory Pallent Group" ("APG") means the Wellpoint Rate that is a fixed reimbursemont to a facility for Outpatient Services and which incorporates data regarding the reason for the visit and patient data. "Ambulatory Paymont Classification" ('APC) or its successor shall have the meaning set forth in the Medicare law and CMS regulations and guidance. "Wellpoint DMEPOS and PEN Fee Schedule" means the applicable Wellpoint DMEPOS and PEN Fee Schedule for thernarket(s) 3qd pgogrqm(s) covered by the Agreement. The parties acknowledge and agreo that the Wellpoint DMEPOS and PEN Fee Schedule ls subJect to modification by Wellpoint at any time during theierm of the Agreement. Wellpoint DMEPOS and PEN Fee Schedule and/or rate changes will be applied on a prospectlve basis. "Wellpoint Roference Laboratory Fee Schedule" means the Wellpolnt Rate that is the Wellpoint Reference Laboratory Fee Schedule that is based on the Medicare Fee Schedule and may contain addltlonal CPT/HCPCS codes. Wellpoint Reference Laboratory Fee Schedule and/or rate changes will be applied on a prospective basis. The Wellpoint Reference lgbor_atqry Fee Schedule contains all codes from the Medicare Clinical Laboratory Fee Schedule, pathology codes from the Medicare Physlclan Fee schedule, and additional codes added by Plan. "Wellpoint Medicaid Rate(s/Fee Sciedule(s/Methodologles" means the Wellpoint Medicaid Rate(s)/Fee Schedule(s/ln effect on the date of service for the provider type(s/service(s) ldentified herein for the applicable Medicbi-d Program(s). "CMS outpatlent Prospective Payment System" ('OPPS) shall have the meaning set forth ln Medicare law and CMS regulations and guidance. lMedical Care Management Rate'means the amount paid by Wellpoint to Provider on a per member per month basis for facilitatlon of collaborative programs meant to manage medical/social/mental health condition$ more effectively. "Medicare Fee Schedulen moans the applicable Medicare Fee Schedule for the provider type(s) identified herein, including payment convercion factor, where applicable, and in effect on the date of the service is initiated to Members. Medicare Fee Schedule and/or rate changes will be applied on a prospective basis, "Medicaro LUPA National Base Rate" means the Medicare LUPA ("Low Utilization Payment Adjustment") National Base rate ln effect as of the date of service for the market(s) and program(s) covered by the Agreement at the time the Covered Services are initiated to the Member. Medlcare LUPA Natlonal Base Rate changes will be applied on a prospective basis, "Medicare P-arlB Dlug Avgrage Sales Price ("ASP") Fee Schedule" means the Medicare Part B Drug Average Sales Pric-e ('ASP") Fee Schedule (or successor) in effect as of the date of service for the market(s) and prbgramstovered by the Agrgeryent at the tlme the covered Services is inltlated to the Member. Medicare Rirt a Orug Average Sales Prlce ("ASP") Fee Schedule and/or rate changes will be applied on a prospective basis. "Washington State Modicald Rate(s)/Fee Schedule(s/Methodologies" means the Washlngton State Medlcald Rate(s/Fee Schedule(s/ in effect on the date of service for the provldor type(s[service(s) identified herein for the applicable Medicaid Program(s). Washlnglon Ent€rprise ProviderAgrcom€nl PCg Altachmenl Medlcald - Speclallst Physlcian Grp @2024 Sept - Wellpolnt Wsshlngtofl, lnc. 1 t 839321 56 06!0a2025 37