| Revenue Code | Description | Adult Max Fee Allowance | Children's Max Fee Allowance |
| OP912 | PARTIAL HOSP LESS INTENSE | 19.89 | 0.00 |
| OP913 | PARTIAL HOSPITAL INTENSIVE | 72.14 | 77.16 |
| OP914 | PSYCHI/PSYCHOLO SERV,INDIV THE | 79.31 | 52.85 |
| OP915 | PSYCHI/PSYCHOLO SERV,GROUP THE | 27.50 | 30.00 |
| OP918 | PSYCHI/PSYCHOLO SERV,TESTING,O | 85.88 | 69.35 |
| OP919 | PSYCHI/PSYCHOLO SERV,OTHER,OUT | 94.88 | 44.39 |