2006 Fee Schedules

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Updates

Payment policies updates

Payment policies updates
Posting date	Description
Mar 30, 2007	IME providers only: Effective March 5, 2007. The following is for State Fund reimbursement to IME providers or panel examiners who process imaged documents from the Claim and Account Center (CAC). Code Description Amount 1132M IME document handling. For only viewing or printing imaged documents within the Medical and/or Vocational Rehabilitation areas of CAC. Unless L&I's referral letter requests you to review all documents. Payable only once per IME referral. $.07 per page Example: L&I requests you to review 850 pages in the Medical and/or Vocational Rehabilitation area(s). You review all pages but, print only 700. Payment would be $59.50 = $.07 X 850 (pgs viewed). 1133M IME document processing. For initial processing of imaged documents within CAC. Payable only once per IME referral. $54.76 flat fee 1129M (For the examiner) IME extensive file review of printed pages, from CAC or microfiche. The first 750 are included in the exam fee. Fee: Is based on number of pages reviewed by the examiner. Starts with 75 pages or portion there of, beyond the first 750 pages. A detailed chronology of the injury or condition must be included in the IME report. Also, not payable with 1111M or 1120M. $51.73 starts with first page after 750 = 751* *Quantity = ((Total pages reviewed - 750)/75) rounded up. Example from CAC: 830 pages reviewed: (830-750=80 /75=1.07) rounded up=(2 X $51.73)= $103.46 Example from Microfiche: The examiner can only count the pages they reviewed. If the examiner receives 12 microfiche and reviews only 200 pages: 200 - 750 = -550 or $0.00. 1100M IME microfiche handling Payable only once per IME referral. $54.76 first 10 microfiche pages 1101M IME microfiche handling Payable only once per IME referral. $5.48 beyond first 10 microfiche pages
Jan 2, 2007	The mileage rate is increasing from $.445 to $.485 effective January 1, 2007. All mileage codes with a description of "State Rate" will be increased accordingly.

Fee schedules updates

Fee schedules updates
Posting date	Description	Updated version
Mar 30, 2007	New HCPCS codes effective April 1, 2007.	HCPCS codes (11 KB PDF)
Mar 30, 2007	Invalid HCPCS codes for dates of service after March 31, 2007.	HCPCS codes (14 KB PDF)
Feb 9, 2007	Additional CPT® codes effective January 1, 2007.	CPT® codes (10 KB PDF)
Jan 2, 2007	New Anesthesia, CPT® and HCPCS codes effective January 1, 2007 (updated).	New codes (108 KB PDF)
Dec 18, 2006	CPT® and HCPCS codes invalid for dates of service after December 31, 2006.	Deleted codes (68 KB PDF)
Nov 28, 2006	Ambulatory Surgery Center new and deleted CPT™ codes and group changes effective January 1, 2007.	ASC codes (25 KB PDF)
Sept 12, 2006	New HCPCS codes effective October 1, 2006	HCPCS codes (19 KB PDF)
Aug 9, 2006	CPT® code changes of the ASC payment group effective October 1, 2006. Code Old Group New Group New Fee 63075 13 11 $3,340.37 63076 13 11 $651.37	N/A
July 1, 2006	CPT® code 83037 has been assigned a fee. The non-facility and facility fee is $18.98.	N/A
July 1, 2006	The non-facility RVU for CPT® code 95991 has been changed. The new non-facility fee is $127.96.	N/A
July 1, 2006	New CPT® codes.	CPT® codes (102 KB PDF).
July 1, 2006	New HCPCS codes.	HCPCS codes (91 KB PDF).

Corrections

Fee schedules corrections

Fee schedules corrections
Posting date	Description	Updated version
Dec 11, 2006	The following changes were inadvertently not listed with the Ambulatory Surgery Center (ASC) CPT® code and group changes posted Nov 28, 2006: Additions effective Jan 1, 2007 CPT® code Group Fee 77002 77003 77012 14 14 14 $72.11 $65.61 $387.67 Deletions effective Jan 1, 2007 76003 76005 76360	N/A
July 12, 2006	A reference to the split billing policy was inadvertently listed within the Daily Maximum paragraph for physical and occupational services (PT/OT). On page 60, of the Professional Payment Policy Section, under Daily Maximum for Services, a reference to Split Billing was inserted in error. Split Billing does not apply to PT/OT services. PT/OT services are paid a daily maximum per claim per provider. The reference to Split Billing has been removed from the documents on this site. We are sorry for the inconvenience.	N/A
July 1, 2006	The fees for HCPCS codes V5008 and V5014 were incorrectly listed in the Payment Policies, Audiology Section, page 113. The correct fees are: V5008 - $71.26 V5014 - $47.51	N/A
July 1, 2006	Corrected fee to HCPCS prosthetic codes that were incorrectly listed in the fee schedule.	Corrected prosthetic codes (13 KB PDF).
July 1, 2006	CPT® Code 62287 was incorrectly listed as Not Covered. Non-Facility Fee = $774.26 Facility Fee = $774.26 ASC Group = 9; ASC Fee = $3036.00	N/A

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