Regulations
| 9789.12.12....Consultation Services Coding - Use of Visit Codes | |
| (a) Maximum fees for physicians and qualified non-physician practitioners performing consultation services shall be determined utilizing the appropriate RVU for a patient ...more | |
| 9789.12.13....Correct Coding Initiative | |
| (a) The National Correct Coding Initiative Edits (âNCCIâ) adopted by the CMS shall apply to payments for medical services under the Physician Fee Schedule. ...more | |
| 9789.12.14....California Specific Codes | |
| Physicians and non-physician practitioners shall use the âCalifornia Specific Codesâ listed below. Maximum reasonable fees for services performed by physicians ...more | |
| 9789.12.15....California Specific Modifier | |
| The following modifier is to be appended to the applicable CPT Code or California Specific code in addition to any applicable CPT modifier. -30 Â Consultation Service ...more | |
| 9789.12.2....Calculation of the Maximum Reasonable Fee - Services Other than Anesthesia | |
| All services shall be assigned the POS code for the setting in which the patient received the face-to-face service. NF Telehealth The location where health services and ...more | |
| 9789.12.3....Status Codes C, I, N and R | |
| Â (b) When procedures with status indicator codes C, N, or R, do not have RVUs assigned under the CMS' National Physician Fee Schedule Relative Value File, these ...more | |
| 9789.12.4....By Report - Reimbursement for Unlisted Procedures/Procedures Lacking RBRVUs | |
| (a) An unlisted procedure shall be billed using the appropriate unlisted procedure code from the CPT. The procedure shall be billed by report (report not separately ...more | |
| 9789.12.5....Conversion Factors | |
| (a) The conversion factors to be used for determining maximum reasonable fees are set forth in section 9789. 19, by date of service. (2) During the transition, the ...more | |
| 9789.12.6....Health Professional Shortage Area Bonus Payment: Primary Care; Mental Health | |
| (a) Physicians who provide professional services in a Health Professional Shortage Area (HPSA) are eligible for a 10-percent bonus payment. Â Physicians, including ...more | |
| 9789.12.7....CMS' National Physician Fee Schedule Relative Value File / Relative Value Units (RVUs) | |
| The National Physician Fee Schedule Relative Value File which is published on the CMS website shall be utilized to determine the maximum reasonable fees. See section ...more | |
