Most Recent Articles

Medical-Legal Cheat Sheet for CA Workers' Comp

It’s official: California workers’ compensation has a new Medical-Legal Fee Schedule (MLFS). The updated MLFS is effective for dates of service on or after April 1, 20...

2021 CA Med-Legal Billing Codes Pocket Guide

California has a new Medical-Legal Fee Schedule (MLFS), effective April 1. To help medical-legal evaluators and their staff navigate these (drastic) changes, we created a dow...

Download: Med-Legal Graphic Workflow (With Modifiers)

Effective April 1, 2021, the Division of Workers’ Compensation adopted an all-new Medical-Legal Fee Schedule, complete with new billing codes and modifiers. Like many things ...

Med-Legal Bill Denied for Liability? Request IBR

Certain California workers’ comp payers deny reimbursement for Medical-Legal evaluations by claiming lack of liability for the initial injury. With this twisted, circular log...

ML106: Liberty Mutual Must Learn the Rules

California’s all-new Medical-Legal Fee Schedule (MLFS) debuted back in April, but some claims administrators are still a few steps behind. To bill for supplemental Med...

CA Med-Legal: ML200 Missed Appointment Payable

An Independent Bill Review (IBR) case affirmed one of the biggest changes to California’s Medical-Legal Fee Schedule (MLFS): an established reimbursement for missed Medical-L...

Med-Legal ML106: IBRs Leave No Doubt

If it wasn’t clear before, it certainly is now. Physicians should bill for supplemental Medical-Legal reports requested before April 1, 2021 with billing code ML106, regardle...

Med-Legal Reports: Always Include Page Count Verification!

Preferred Provider Organization (PPO) and other network discounts do not apply to the Medical-Legal Fee Schedule (MLFS). Period.In other words, the MLFS and OMFS are c...

Med-Legal Diagnostic Testing Is Reimbursable

FAQ: Is diagnostic testing, as part of a Medical-Legal evaluation, separately reimbursable?A: Yes, as long as the testing is necessary to complete the evaluation.<...

AIG: Improper (but Logical) Med-Legal Underpayment

AIG improperly reduced a California Medical-Legal bill by 88%, providing a dramatic example of how California law incentivizes payers to incorrectly reimburse physicians who ...

Med-Legal Reports: Always Include Page Count Verification!

California’s new Medical-Legal Fee Schedule (MLFS), effective from April 2021, brought with it new rules for reporting, billing, and payment. Among those rules: when submitti...

MLFS Billing Tip: CA Med-Legal Deadlines Extended

As providers continue to grapple with COVID-19’s impact on healthcare systems, California Medical-Legal examiners (and workers’ comp claims administrators) are reminded: the ...