Regulations
| 9789.13.1....Supplies | |
| (a) Separate payment for routinely bundled supplies is not allowed. Â (c) Splints and casting supplies are payable separately in addition to payment for the procedure ...more | |
| 9789.16.1....Surgery - Global Fee | |
| The National Physician Fee Schedule Relative Value File, Global Days column (labeled âGlob Daysâ), provides the postoperative periods that apply to each ...more | |
| 9789.16.2....Surgery - Billing Requirements for Global Surgeries | |
| Â Physicians who perform the surgery and furnish all of the usual pre-and postoperative work bill for the global package by entering the appropriate CPT code for the ...more | |
| 9789.16.3....Surgery - Global Fee - Miscellaneous Rules | |
| When both correct coding and global surgery edits apply to the same claim, the claims administrator shall first apply the correct coding edits, then, apply the global ...more | |
| 9789.16.4....Surgery - Global Fee; Exception: Circumstances Allowing E&M Code During the Global Period; Primary Treating Physician's Progress Report (PR-2) | |
| (a) Notwithstanding sections 9789. 16. 2 - 9789. 16. 3, where a surgical code is subject to a global period, the provider may separately bill an E&M service during the ...more | |
| 9789.16.5....Surgery - Multiple Surgeries and Endoscopies | |
|  (b) Billing Instructions  The following procedures apply when billing for multiple surgeries by the same physician on the same day. In such cases, the physician ...more | |
| 9789.16.6....Surgery - Bilateral Surgeries | |
| The payment adjustment rules for bilateral surgeries do not apply to procedures identified by CPT as âbilateralâ or âunilateral or bilateralâ since ...more | |
| 9789.16.7....Surgery - Co-Surgeons and Team Surgeons | |
| If the surgery is billed with a â-62â modifier and the Co-Surgeons column contains an indicator of â2,â payment rules for two surgeons apply. Â If ...more | |
| 9789.16.8....Surgery - Assistants-at-Surgery | |
| Â Procedures billed with the assistant-at-surgery physician modifiers -80, -81, -82, or the AS modifier for physician assistants, nurse practitioners and clinical ...more | |
| 9791....Services Covered | |
| Except as provided in this article, the Official Medical Fee Schedule applies to all covered medical services provided, referred or prescribed by physicians (as defined ...more | |
