Evaluation & Management Services

WCIRB Report Obscures CA Workers' Comp's Real Challenges

A report from the Workers’ Compensation Insurance Rating Bureau (WCIRB) of California asserts that in 2021, “overall medical payments per claim increased significantly.” Howe...

CA OMFS: E/M Reimbursement vs Medicare Reimbursement

California workers’ comp allows discount networks to bleed the doctors who treat injured workers. Unfortunately for these workers and their employers, many of these financial...

2022 E/M Reimbursement Rates for CA Workers' Comp - Facility

California’s Division of Workers’ Compensation recently posted new reimbursement rates for Evaluation and Management (E/M) services. Below we list the new facility reimbursem...

2022 E/M Reimbursement for CA Workers' Comp - Non-Facility

California’s Division of Workers’ Compensation recently posted new reimbursement rates for Evaluation and Management (E/M) services. Below we list the new non-facility reimbu...

E/M: Not the PTP? How to Bill for Required Reports

For Evaluation and Management (E/M) in California workers’ comp, Primary Treating Physicians (PTP) must submit with the bill a progress report using either the ...

Travelers, SCIF Incorrectly Apply New E/M Rules Before Effective Dates

Every year, we see claims administrators incorrectly deny reimbursement because they fail to keep up with the latest changes to the Official Medical Fee Schedule (OMFS). But ...

How to Apply HCPCS G2212 in CA Workers' Comp

Important Update: The DWC adopted an MUE limiting the number of units of G2212 providers may bill. Details below!This year, California’s Division of Workers’ Compensat...

2021 Facility E/M Reimbursement Rates for CA Workers' Comp

Evaluation and Management (E/M) billing is very different for California workers’ comp physicians in 2021. Among the changes to the Physician Fee Schedule are new reim...

2021 E/M Reimbursement Rates for CA Workers' Comp

As we reported previously, California’s Division of Workers’ Compensation made major changes to Evaluation and Management (E/M) billing for 2021. In addition to updati...

CA OMFS: E/M Billing - 2021 Major Changes

Effective March 1, updates to California’s Physician and Non-Physician Practitioner Fee Schedule significantly alter the way providers bill for Evaluation and Management (E/M...

2020 CA Workers’ Comp E/M Cheat Sheet

Hooray! In 2020 reimbursements increased across the board for Evaluation & Management (E&M) codes!Below we’ve compiled a nifty reimbursement cheat sheet for the seven ...

2019 CA Workers’ Comp Evaluation & Management Cheat Sheet

The 2019 changes to California’s reimbursements got your head spinning? Here’s a handy reimbursement cheat sheet for the most frequently used Evaluation & Management codes.