Site Alert

Most of our online systems will be unavailable from 6 a.m. to 2 p.m. on Saturday, November 22, 2014, for scheduled system upgrades. We apologize for any inconvenience.

2013 MARFS

Billing & Payment Policies

Effective July 1, 2013

 

Go Back Return to Fee Schedule Lookup

These billing and payment policies determine under what conditions we will pay health care and vocational providers who treat injured workers and crime victims.

Note: Make sure to check the Updates & Corrections tab for any changes to the Payment policies.

Payment Policies - PDF fileComplete (5.57 MB PDF)
Chapter # Title
1
Introduction
2
Information for All Providers
Professional Services
3
Ambulance Services
4
Anesthesia Services
5
Audiology and Hearing Services
6
Biofeedback, Electrodcardiograms (EKG), Electrodiagnostic services, and Extracorporeal shockwave therapy (ESWT)
7
Chiropractic Services
8
Dental Services
9
Durable Medical Equipment (DME)
10
Evaluation and Management (E/M) Services
11
Home Health Services
12
Impairment Rating Services
13
Independent Medical Exams (IME)
14
Interpretive Services
15
Medical Testimony
16
Medication Administration and Injections
17
Modifications: Home, Job, and Vehicle
18
Naturopathic Physicians
19
Nurse Case Management
20
Obesity Treatment
21
Other Services
22
Pathology and Laboratory Services
23
Pharmacy Services
24
Physical Medicine Services
25
Psychiatric Services
26
Radiology Services
27
Reports and Forms
28
Supplies, Materials, and Bundled Services
29
Surgery Services
30
Vocational Services
31
Washington RBRVS Payment System
Facility Services
32
Ambulatory Surgery Centers (ASCs)
33
Brain Injury Rehabilitation Services
34
Chronic Pain Management
35
Hospitals
36
Nursing Home and Other Residential Care Services
Appendices
A Bundled Services
B Bundled Supplies
C Documentation requirements
D Endoscopy families
E Modifiers that affect payment
F Noncovered codes and modifiers
G Outpatient drug formulary

Unless noted, all policies in the Medical Aid Rules and Fee Schedules apply to claimants receiving benefits from either the State Fund, the Crime Victims Compensation Program or Self-Insurers.

Providers must follow the administrative rules, medical coverage decisions and payment policies applicable to L&I. You can find this information in the Medical Aid Rules and Fee Schedules, Provider Bulletins and Provider Updates.

End of main content, page footer follows.

Access Washington official state portal

© Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.