 |
California Code of Regulations (Last Updated: August 6, 2014) |
 |
Title 8. Industrial Relations |
|
|
Division 1. Department of Industrial Relations |
|
|
Chapter 4.5. Division of Workers' Compensation |
|
|
Subchapter 1. Administrative Director -Administrative Rules |
|
|
Article 5.3. Official Medical Fee Schedule |
| Article 5.3. Official Medical Fee Schedule |
| § 9789.10. Physician Services - Definitions. |
| § 9789.11. Physician Services Rendered on or After July 1, 2004. |
| § 9789.12.1. Physician Fee Schedule: Official Medical Fee Schedule for Physician and Non-Physician Practitioner Services - for Services Rendered on or After January 1, 2014. |
| § 9789.12.2. Calculation of the Maximum Reasonable Fee - Services Other than Anesthesia. |
| § 9789.12.3. Status Codes C, I, N and R. |
| § 9789.12.4. ‘‘by Report” - Reimbursement for Unlisted Procedures/Procedures Lacking Rbrvus. |
| § 9789.12.5. Conversion Factors. |
| § 9789.12.6. Health Professional Shortage Area Bonus Payment: Primary Care; Mental Health. |
| § 9789.12.7. Cms' National Physician Fee Schedule Relative Value File / Relative Value Units (Rvus). |
| § 9789.12.8. Status Codes. |
| § 9789.12.9. Professional Component (pc)/Technical Component (tc) Indicator. |
| § 9789.12.10. Coding; Current Procedural Terminology%2e, Fourth Edition. |
| § 9789.12.11. Evaluation and Management: Coding - New Patient; Documentation. |
| § 9789.12.12. Consultation Services Coding - Use of Visit Codes. |
| § 9789.12.13. Correct Coding Initiative. |
| § 9789.12.14. California Specific Codes. |
| § 9789.12.15. California Specific Modifier. |
| § 9789.13.1. Supplies. |
| § 9789.13.2. Physician-Administered Drugs, Biologicals, Vaccines, Blood Products. |
| § 9789.13.3. Physician-Dispensed Drugs. |
| § 9789.14. Reimbursement for Reports, Duplicate Reports, Chart Notes. |
| § 9789.15.1. Non-Physician Practitioner (Npp) - Payment Methodology. |
| § 9789.15.2. Non-Physician Practitioner (Npp) - ‘‘Incident to” Services. |
| § 9789.15.3. Qualified Non-Physician Anesthetist Services. |
| § 9789.15.4. Physical Medicine/Chiropractic/Acupuncture Multiple Procedure Payment Reduction; Pre-Authorization for Specified Procedure/Modality Services. |
| § 9789.15.5. Ophthalmology Multiple Procedure Reduction. |
| § 9789.15.6. Diagnostic Cardiovascular Procedures - Multiple Procedure Reduction. |
| § 9789.16.1. Surgery - Global Fee. |
| § 9789.16.2. Surgery - Billing Requirements for Global Surgeries. |
| § 9789.16.3. Surgery - Global Fee - Miscellaneous Rules. |
| § 9789.16.4. Surgery - Global Fee; Exception: Circumstances Allowing E&M Code During the Global Period; Primary Treating Physician's Progress Report (PR-2). |
| § 9789.16.5. Surgery - Multiple Surgeries and Endoscopies. |
| § 9789.16.6. Surgery - Bilateral Surgeries. |
| § 9789.16.7. Surgery - CO-Surgeons and Team Surgeons. |
| § 9789.16.8. Surgery - Assistants-at-Surgery. |
| § 9789.17.1. Radiology Diagnostic Imaging Multiple Procedures. |
| § 9789.17.2. Radiology Consultations. |
| § 9789.18.1. Payment for Anesthesia Services - General Payment Rule. |
| § 9789.18.2. Anesthesia - Personally Performed Rate. |
| § 9789.18.3. Anesthesia - Medically Directed Rate. |
| § 9789.18.4. Anesthesia - Definition of Concurrent Medically Directed Anesthesia Procedures. |
| § 9789.18.5. Anesthesia - Medically Supervised Rate. |
| § 9789.18.6. Anesthesia - Multiple Anesthesia Procedures. |
| § 9789.18.7. Anesthesia - Medical and Surgical Services Furnished in Addition to Anesthesia Procedure. |
| § 9789.18.8. Anesthesia - Time and Calculation of Anesthesia Time Units. |
| § 9789.18.9. Anesthesia - Base Unit Reduction for Concurrent Medically Directed Procedures. |
| § 9789.18.10. Anesthesia - Monitored Anesthesia Care. |
| § 9789.18.11. Anesthesia Claims Modifiers. |
| § 9789.18.12. Anesthesia and Medical/Surgical Service Provided by the Same Physician. |
| § 9789.19. Update Table. |
| § 9789.20. General Information for Inpatient Hospital Fee Schedule - Discharge on or After July 1, 2004. |
| § 9789.21. Definitions for Inpatient Hospital Fee Schedule. |
| § 9789.22. Payment of Inpatient Hospital Services. |
| § 9789.23. Hospital Cost to Charge Rations, Hospital Specific Outliers, and Hospital Composite Factors. |
| § 9789.24. Diagnostic Related Groups, Relative Weights, Geometric Mean Length of Stay. |
| § 9789.25. Federal Regulations, Federal Register Notices, and Payment Impact File by Date of Discharge. |
| § 9789.30. Hospital Outpatient Departments and Ambulatory Surgical Centers - Definitions. |
| § 9789.31. Hospital Outpatient Departments and Ambulatory Surgical Centers - Adoption of Standards. |
| § 9789.32. Outpatient Hospital Department and Ambulatory Surgical Center Fee Schedule - Applicability. |
| § 9789.33. Hospital Outpatient Departments and Ambulatory Surgical Facilities Fee Schedule - Determination of Maximum Reasonable Fee. |
| § 9789.34. Table A. |
| § 9789.35. Table B. |
| § 9789.36. Update of Rules to Reflect Changes in the Medicare Payment System. |
| § 9789.37. Dwc Form 15 Election for High Cost Outlier. |
| § 9789.38. Appendix X. |
| § 9789.39. Federal Regulations and Federal Register Notices by Date of Service. |
| § 9789.40. Pharmacy. |
| § 9789.50. Pathology and Laboratory. |
| § 9789.60. Durable Medical Equipment, Prosthetics, Orthotics, Supplies. |
| § 9789.70. Ambulance Services. |
| § 9789.80. Skilled Nursing Facility. [Reserved] |
| § 9789.90. Home Health Care. [Reserved] |
| § 9789.100. Outpatient Renal Dialysis. [Reserved] |
| § 9789.110. Update of Rules to Reflect Changes in the Medicare Payment System. |
| § 9789.111. Effective Date of Fee Schedule Provisions. |