Fee Schedule
Apr 5, 2019
8 Minute How-To: Multiple Procedure Payment Reduction (MPPR)
This short, free, and super-useful video demystifies Multiple Procedure Payment Reductions (MPPRs) for Physician and Non-Physician Practitioner Services in California.
Mar 29, 2019
9 Minute How-To: Geographic Practice Cost Indices (GPCIs)
Confused by the 2019 introduction of Geographic Practice Cost Indices (GPCIs) to Physician Services reimbursements?In just nine minutes you will know the reason Fresno...
Mar 4, 2019
Assistant at Surgery: All You Need to Know
Last week, we opened Pandora’s box on co-surgeons and team surgery. Notably left in the box was a discussion on assistant(s) at surgery. Typically this arises when physicians...
Mar 1, 2019
📬 Payer Responses: Guile, Waiting, and Crickets 🏏
Today we report on the responses from Sedgwick, Liberty Mutual, York, and State Compensation Insurance Fund (SCIF), following our posts detailing their systematic underpaymen...
Feb 26, 2019
Co-Surgery vs. Team Surgery: All You Need to Know
Surgery in workers’ compensation cases opens a Pandora’s box: reserves go up, nurse case managers get involved, and surgeons need to justify every detail of their billing to ...
Feb 15, 2019
Liberty Mutual Trifecta of Incorrect Payments
In this, our fourth story on the fiasco of 2019 workers’ comp payments, we turn to the errors of Liberty Mutual. By now, from reading about Sedgwick, York, and Sedgwick (agai...
Feb 8, 2019
The Payment Chaos Continues: Sedgwick Denies Appeal for Correct 2019 Reimbursements
Sedgwick’s payment mistakes multiply. First, Sedgwick incorrectly paid California providers by applying an old workers’ comp fee schedule. Now Sedgwick compounds its error by...
Feb 6, 2019
2019 Splinting & Casting Reimbursement Update
When navigating the seas of change, it’s refreshing to find an island of relative stability. Like California’s state-specific codes, the splinting and casting codes group (co...
Feb 4, 2019
California-Specific Codes Updated for 2019
With the flurry of new year fee schedule changes, California updated the Physician Fee Schedule reimbursement for its state-specific codes. These codes are explained in 8 CCR...
Feb 1, 2019
Sedgwick Still Reimbursing at 2018 Rates for California
Since the beginning of 2019, Sedgwick CMS has incorrectly used the 2018 Physician Fee Schedule to reimburse providers. Our data indicates that Sedgwick is consistently and in...
Jan 23, 2019
Good-bye CPT 96101 and CPT 96102
For 2019 beloved psychological testing codes 96101 and 96102 have vanished. Effective for dates of service on or after January 1, 2019, the Medicine/Central Nervous ...
Nov 29, 2018
CA OMFS Inpatient Hospital Fee Schedule Update
California’s Division of Workers’ Compensation (DWC) posted an adjustment to the Inpatient Hospital section of the Official Medical Fee Schedule (OMFS), effective for dischar...