Fee Schedules

2022 Fee Schedules

Effective July 1, 2022

This site contains the policies, payment methods, billing codes, and maximum fees used to pay health care and vocational providers who treat injured workers.

Make sure to check the Updates & Corrections tab for any changes to the Fee schedules. Read about the highlights of changes in the last year. These changes are also included in the payment policies.

Please make sure to review our Temporary Telehealth Payment Policies on the tab above.

Professional and Facility Services Fee Schedules (July 2022)

Note: These fee schedules have been enhanced with search features for your convenience.

  • Professional Services Fee Schedule — Excel spreadsheet of the complete fee schedule excluding the ASC Fees, AP-DRGs, Hospital Rates and Residential Facility Rates. This fee schedule has been enhanced with a search feature for your convenience.

Note: For your reference here are the code ranges you will find in the professional fee schedule.

    • Evaluation and Management — CPT™ 99202 - 99499
    • Surgery — CPT™ 10004 - 69979
    • Radiology — CPT™ 70010 - 79999
    • Pathology and Laboratory — CPT™ 80047 - 89398 and 0001U - 0222U
    • Medicine — CPT™ 90281 - 99607
    • CPT ™ Category II and III — CPT™ 0001F - 0639T
    • HCPCS — HCPCS A0021 - V5364
    • Medical and Surgical Supplies Codes — HCPCS A4206 - A9999 (For DME Providers)
    • Facility Only Codes — C1300 - S0093
    • Local Codes — Local Codes Listed by Specialty                                                           

Fee Schedules - Comma delimited version with Field Key

Billing & Payment Policies

2022 Billing & Payment Policies

Effective July 1, 2022

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 Complete  (2022)

Professional Services

Facility Services

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.

Updates & Corrections

2022 Updates and Corrections

Updates

Payment policy updates

Posting date Policy Area Description

Fee schedule updates

Posting date

Description Updated Version
05/31/2022 New HCPCS and Deleted HCPCS codes. See file for effective dates.​ New and Deleted HCPCS July 2022

Corrections

Payment policy corrections

Posting date Policy Area Description

Fee schedule corrections

Posting date Description Updated Version

Temporary Telehealth Policies

Temporary Telehealth Payment Policies

Posting date Policy Area Description
6/30/2022 Temporary Telehealth IME and Record Review Policy​ To help support containment of the COVID-19 outbreak, the Temporary IME and Record Review policy allows temporary coverage for independent medical examiners to complete exams via telehealth. This policy is effective 3/9/2020 and expires 12/31/2022​. This is an emerging situation, and this policy may be updated as needed.​ ​