ML201 / MLPRR - State Compensation Insurance Fund (CA): Grade A

ML201 / MLPRR - State Compensation Insurance Fund (CA): Grade A

Claims administrator properly processed reimbursement for ML201 and MLPRR. Date of Service: 04/26/2021

MLFS Code(s)

ML201 - Comprehensive Medical-Legal Evaluation

MLPRR - Record Review

MLFS Modifier(s)

95 - Evaluation performed by a panel selected Qualified Medical Evaluator

96 - Evaluation performed by a Psychiatrist or Psychologist

MLFS Grade

A

Claims Administrator

State Compensation Insurance Fund (CA)

Bill Review Vendor

State Compensation Insurance Fund (CA)

Employer

Dept of Financial Protection and Innovation

Expected Fee Schedule

$4,669.00

Bill Payment Total

$4,669.00

Bill Processing Day Count

6 days to process bill from submission


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