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Regulations



 
9789.12.8....Status Codes
The Medicare Status Codes have been adapted for worser's compensation and have the following meanings:  A =    Active Code.   These codes are paid ...more
 
 
9789.12.9....Professional Component (PC)/Technical Component (TC) Indicator
The total RVUs for professional component only codes include values for physician work, practice expense, and malpractice expense. =   Technical Component Only ...more
 
 
9789.13.1....Supplies
(a) Separate payment for routinely bundled supplies is not allowed.   (c) Splints and casting supplies are payable separately in addition to payment for the procedure ...more
 
 
9789.13.2....Physician-Administered Drugs, Biologicals, Vaccines, Blood Products
(a) Physician-administered drugs, biologicals, vaccines, or blood products are separately payable. Other physician-administered drugs, biological and blood products shall ...more
 
 
9789.13.3....Physician-Dispensed Drugs
The maximum reimbursement for physician-dispensed drugs is determined pursuant to the Pharmaceutical Fee Schedule set forth in section 9789. 40 and pursuant to the ...more
 
 
9789.14....Reimbursement for Reports, Duplicate Reports, Chart Notes
  (4) Physician's Return-to-Work & Voucher Report (DWC-AD 10133. 36) issued in accordance with section 9785 subdivision (i) (reimbursement is bundled into payment for ...more
 
 
9789.15.1....Non-Physician Practitioner (NPP) - Payment Methodology
  (b) Except for clinical social workers, maximum fees for NPP services shall be 85 percent of what a physician is paid under the Official Medical Fee Schedule - ...more
 
 
9789.15.2....Non-Physician Practitioner (NPP) - “Incident To” Services
  (2) NPPs may provide services without direct physician supervision and bill directly for these services. When their services are provided under direct physician ...more
 
 
9789.15.3....Qualified Non-Physician Anesthetist Services
  (b) The maximum fee for anesthesia services furnished by qualified non-physician anesthetists is the fee determined by this section and section 9789. 18. 1.   ...more
 
 
9789.15.4....Physical Medicine/Chiropractic/Acupuncture Multiple Procedure Payment Reduction; Pre-Authorization for Specified Procedure/Modality Services
  (2) Many therapy services are time-based codes, i. e. , multiple units may be billed for a single procedure. The MPPR applies to the Practice Expense ...more
 
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