Policy 2023

Fee Schedules

2023 Fee Schedules

Effective July 1, 2023

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.

2023 Quick Reference Fee Schedule (English) Español (Spanish)

Professional and Facility Services Fee Schedules (July 2023)

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

Anesthesia — CPT™ 00100 - 01999
ASC Fee Schedules — All approved codes
APR-DRG Assignment — Version 38
Hospital Rates
Residential Facility Rates

Fee Schedules - Comma delimited version with Field Key

Complete fee schedule excluding the ASC Fees, AP-DRGs, Hospital Rates and Residential Facility Rates, Field Key
Anesthesia
Ambulatory Surgery Center, Field Key
APR-DRG, Field Key
Hospital, Field Key

Billing & Payment Policies

2023 Billing & Payment Policies

Effective July 1, 2023

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 (2023)

Chapter 1 - Introduction
Chapter 2 - Information for All Providers

Professional Services

Chapter 3 - Ambulance Services
Chapter 4 - Anesthesia Services
Chapter 5 - Audiology and Hearing Services
Chapter 6 - Biofeedback, Electrocardiograms (EKG), Electrodiagnostic services, and Extracorporeal shockwave therapy (ESWT)
Chapter 7 - Chiropractic Services
Chapter 8 - Dental Services
Chapter 9 - Durable Medical Equipment (DME)
Chapter 10 - Evaluation and Management (E/M) Services
Chapter 11 - Home Health Services
Chapter 12 - Impairment Rating Services
Chapter 13 - Independent Medical Exams (IME)
Chapter 14 - Language Access Services
Chapter 15 - Medical Testimony
Chapter 16 - Medication Administration and Injections
Chapter 17 - Mental Health Services
Chapter 18 - Modifications: Home, Job, and Vehicle
Chapter 19 - Naturopathic Physicians and Acupuncture Services
Chapter 20 - Nurse Case Management
Chapter 21 - Obesity Treatment
Chapter 22 - Other Services
Chapter 23 - Pathology and Laboratory Services
Chapter 24 - Pharmacy Services
Chapter 25 - Physical Medicine Services
Chapter 26 - Radiology Services
Chapter 27 - Reports and Forms
Chapter 28 - Supplies, Materials, and Bundled Services
Chapter 29 - Surgery Services
Chapter 30 - Vocational Services
Chapter 31 - Washington RBRVS Payment System

Facility Services

Chapter 32 - Ambulatory Surgery Centers (ASCs)
Chapter 33 - Brain Injury Rehabilitation Services
Chapter 34 - Chronic Pain Management
Chapter 35 - Hospitals
Chapter 36 - Nursing Home and Other Residential Care 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

2023 Updates and Corrections

Updates

Payment policy updates

Posting date	Policy Area	Description

Fee schedule updates

Posting date	Description	Updated Version

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
12/01/2022	Temporary IME Telehealth Policy	The Temporary IME Telehealth Policy allows temporary coverage for independent medical examiners to complete exams via telehealth. This policy is effective 1/1/2023 and expires 6/30/2023. This is an emerging situation, and this policy may be updated as needed.
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.