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§ 9789.14 Reimbursement for Reports, Duplicate Reports, Chart Notes

Summary

For medical services rendered on and after January 1st, 2014, the RBRVU Physician Fee schedule consists of 48 Regulations, including 40 fee-affecting regulations. Knowing and understanding these additional fee-affecting regulations is critical to determining the correct reimbursement for services.

Section 9789.14 defines the reimbursement regulations for reports, duplicate reports, and chart notes.

Primary Treating Physician (PTP) Reports

Section 9789.14 lists the three separately reimbursable Primary Treating Physician reports, which are the PR-2, PR-3, and PR-4.

Psychiatric Reports

Section 9789.14 also lists the only instance when the Physician Fee Schedule reimburses psychiatric reports. Other than for med-legal purposes, for reimbursement, a psychiatric report must be requested by either the WCAB or the Administrative Director.

Consultation Reports

Section 9789.14 also lists the only instance when the Physician Fee Schedule reimburses consultation reports. For reimbursement, a consultation report must be requested by the WCAB or the Administrator Director or an AME or QME.

California Code of Regulations (CCR)

§ 9789.14 Reimbursement for Reports, Duplicate Reports, Chart Notes

Division of Workers’ Compensation Websites

Official Medical Fee Schedule

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