Common use of HCPCS Codes Clause in Contracts

HCPCS Codes. All covered services for HCPCS codes, with the exception of J Codes will be [****]. • Drugs, Immunizations, Vaccinations and Injectables: [****] be utilized for reimbursement for drugs, immunizations or injectables. These drugs and/or immunizations will be reimbursed [****]. Group agrees that in the event that Group employs, subcontracts or independently contracts with or uses the services of a physician extender (that is, a physician assistant, advanced registered nurse practitioner, certified registered nurse anesthetist certified nurse midwife certified surgical assistant, certified registered nurse first assistant or such other similarly situated individual) who will be providing services to Members under the supervision of Group, Group shall notify ChoiceCare in writing, upon execution of this Agreement and at any time during the term of this Agreement when such physician [****] Certain information on this page has been omitted and filed separately with the Commission. Confidential treatment has been requested with respect to the omitted portions. ATTACHMENT B PHYSICIAN REIMBURSEMENT extenders are employed, subcontracted or independently contracted with Group, and the specific services that such physician extenders will be performing, prior to the provision of services to any Member. Group represents that physician extenders employed by or under contract with Group will comply with the terms and condition of this Agreement, maintain professional liability coverage and are appropriately licensed as required by applicable state and federal laws, rules and regulations. Group acknowledges and agrees ChoiceCare retains the right to approve, suspend and/or terminate participation under this Agreement of any physician extender who will be providing services to Members. Payor, in its sole discretion, may reimburse Group for services of such physician extenders rendered to Members covered under Plans offered by Payors with access to ChoiceCare Network and not otherwise specified in paragraphs B and/or C below, [****],whichever is less, less any Co-payments due from Member.

HCPCS Codes. All covered services for HCPCS codes, with the exception of J Codes will be [****]] of fixed 2006 Medicare RBRVS. • Drugs, Immunizations, Vaccinations and Injectables: [****] ChoiceCare’s (201-544) Fee Schedule be utilized for reimbursement for drugs, immunizations or injectables. These drugs and/or immunizations will be reimbursed [****]] ChoiceCare’s (201-544) Fee Schedule. Group agrees that in the event that Group employs, subcontracts or independently contracts with or uses the services of a physician extender (that is, a physician assistant, advanced registered nurse practitioner, certified registered nurse anesthetist certified nurse midwife certified surgical assistant, certified registered nurse first assistant or such other similarly situated individual) who will be providing services to Members under the supervision of Group, Group shall notify ChoiceCare in writing, upon execution of this Agreement and at any time during the term of this Agreement when such physician [****] Certain information on this page has been omitted and filed separately with the Commission. Confidential treatment has been requested with respect to the omitted portions. ATTACHMENT B PHYSICIAN REIMBURSEMENT extenders are employed, subcontracted or independently contracted with Group, and the specific services that such physician extenders will be performing, prior to the provision of services to any Member. Group represents that physician extenders employed by or under contract with Group will comply with the terms and condition of this Agreement, maintain professional liability coverage and are appropriately licensed as required by applicable state and federal laws, rules and regulations. Group acknowledges and agrees ChoiceCare retains the right to approve, suspend and/or terminate participation under this Agreement of any physician extender who will be providing services to Members. Payor, in its sole discretion, may reimburse Group for services of such physician extenders rendered to Members covered under Plans offered by Payors with access to ChoiceCare Network and not otherwise specified in paragraphs B and/or C below, [****],] of ChoiceCare’s (079-787) Fee Schedule or Group’s billed charges, whichever is less, less any Co-payments due from Member.

HCPCS Codes. All covered services for HCPCS codes, with the exception of J Codes codes, will be reimbursed at [****] of fixed 2006 Medicare RBRVS. • CPT CODE 99070 CPT CODE 99070 will be [****]. Humana reserves the right to audit to insure accuracy. • Drugs, Immunizations, Vaccinations Vaccines and Injectables: [****] ChoiceCare’s (201-544) fee schedule will be utilized for reimbursement for drugs, immunizations or injectables. These drugs and/or immunizations will be reimbursed at [****]] of ChoiceCare’s (201-544) fee schedule. Group agrees that in the event that Group employs, subcontracts or independently contracts with or uses the services of a physician extender (that is, a physician assistant, advanced registered nurse practitioner, certified registered nurse anesthetist anesthetist, certified nurse midwife midwife, certified surgical assistant, certified registered nurse first assistant or such other similarly situated individual) who will be providing services to Members under the supervision of Group, Group shall notify ChoiceCare in writing, upon execution of this Agreement and at any time during the term of this Agreement when such physician [****] Certain information on this page has been omitted and filed separately with the Commission. Confidential treatment has been requested with respect to the omitted portions. ATTACHMENT B PHYSICIAN REIMBURSEMENT extenders are employed, subcontracted or independently contracted with Group, and the specific services that such physician extenders will be performing, prior to the provision of services to any Member. Group represents that physician extenders employed by or under contract with Group will comply with the terms and condition of this Agreement, maintain professional liability coverage and are appropriately licensed as required by applicable state and federal laws, rules and regulations. Group acknowledges and agrees ChoiceCare retains the right to approve, suspend and/or terminate participation under this Agreement of any physician extender who will be providing services to Members. Payor, in its sole discretion, may reimburse Group for services of such physician extenders rendered to Members covered under Plans offered by Payors with access to ChoiceCare Network and not otherwise specified in paragraphs B and/or C below, [****],] of ChoiceCare’s (079-787) Fee Schedule or Group’s billed charges, whichever is less, less any Co-payments due from Member.. Except as specifically amended hereby, the terms and conditions of this agreement remain the same. [****] Certain information on this page has been omitted and filed separately with the Commission. Confidential treatment has been requested with respect to the omitted portions. IN WITNESS WHEREOF, the undersigned have executed this Amendment effective March 1, 2009. Provider By: /s/ Xxxxxx Xxxxxx Printed Name: Xxxxxx Xxxxxx Title: CEO Date: 2/26/09 HUMANA By: /s/ Xxxxxx Xxxxxxxx Printed Name: Xxxxxx Xxxxxxxx Title: V.P. Network Management Date: 3-3-09 AMENDMENT TO WhiteGlove Health, Inc. PARTICIPATION AGREEMENT

HCPCS Codes. All covered services for HCPCS codes, with the exception of J Codes codes, will be reimbursed at [****]. • CPT CODE 99070 CPT CODE 99070 will be [****]. Humana reserves the right to audit to insure accuracy. • Drugs, Immunizations, Vaccinations Vaccines and Injectables: [****] ChoiceCare’s (201-544) fee schedule will be utilized for reimbursement for drugs, immunizations or injectables. These drugs and/or immunizations will be reimbursed at [****]. Group agrees that in the event that Group employs, subcontracts or independently contracts with or uses the services of a physician extender (that is, a physician assistant, advanced registered nurse practitioner, certified registered nurse anesthetist anesthetist, certified nurse midwife midwife, certified surgical assistant, certified registered nurse first assistant or such other similarly situated individual) who will be providing services to Members under the supervision of Group, Group shall notify ChoiceCare in writing, upon execution of this Agreement and at any time during the term of this Agreement when such physician [****] Certain information on this page has been omitted and filed separately with the Commission. Confidential treatment has been requested with respect to the omitted portions. ATTACHMENT B PHYSICIAN REIMBURSEMENT extenders are employed, subcontracted or independently contracted with Group, and the specific services that such physician extenders will be performing, prior to the provision of services to any Member. Group represents that physician extenders employed by or under contract with Group will comply with the terms and condition of this Agreement, maintain professional liability coverage and are appropriately licensed as required by applicable state and federal laws, rules and regulations. Group acknowledges and agrees ChoiceCare retains the right to approve, suspend and/or terminate participation under this Agreement of any physician extender who will be providing services to Members. Payor, in its sole discretion, may reimburse Group for services of such physician extenders rendered to Members covered under Plans offered by Payors with access to ChoiceCare Network and not otherwise specified in paragraphs B and/or C below, [****],] of ChoiceCare’s (079-787) Fee Schedule or Group’s billed charges, whichever is less, less any Co-payments due from Member.. Except as specifically amended hereby, the terms and conditions of this agreement remain the same. [****] Certain information on this page has been omitted and filed separately with the Commission. Confidential treatment has been requested with respect to the omitted portions. Provider By: Printed Name: Title: Date: HUMANA By: Printed Name: Xxxxxx Xxxxxxxx Title: V.P. Network Management Date: AMENDMENT TO WhiteGlove House Call Health, Inc. PARTICIPATION AGREEMENT