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Timely Payment

Last update
October 11, 2024

Undisputed workers' compensation medical bills are due within 45 days of receipt for nongovernmental entities and within 60 days of receipt for government entities in California.

State

California

Timely Payment

45 days (60 days for government entities)

California Labor Code

LABOR CODE - LAB DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002]  ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) PART 2. COMPUTATION OF COMPENSATION [4451 - 4856]  ( Part 2 enacted by Stats. 1937, Ch. 90. ) CHAPTER 2. Compensation Schedules [4550 - 4856]  ( Chapter 2 enacted by Stats. 1937, Ch. 90. )  ARTICLE 2. Medical and Hospital Treatment [4600 - 4615]  ( Article 2 enacted by Stats. 1937, Ch. 90. ).

Rule

4603.2

Rule Text

(b)(2) Except as provided in subdivision (d) of Section 4603.4, or under contracts authorized under Section 5307.11, payment for medical treatment provided or prescribed by the treating physician selected by the employee or designated by the employer shall be made at reasonable maximum amounts in the official medical fee schedule, pursuant to Section 5307.1, in effect on the date of service. Payments shall be made by the employer with an explanation of review pursuant to Section 4603.3 within 45 days after receipt of each separate itemization of medical services provided, together with any required reports and any written authorization for services that may have been received by the physician. If the itemization or a portion thereof is contested, denied, or considered incomplete, the physician shall be notified, in the explanation of review, that the itemization is contested, denied, or considered incomplete, within 30 days after receipt of the itemization by the employer. An explanation of review that states an itemization is incomplete shall also state all additional information required to make a decision.

(3) Notwithstanding paragraph (1), if the employer is a governmental entity, payment for medical treatment provided or prescribed by the treating physician selected by the employee or designated by the employer shall be made within 60 days after receipt of each separate itemization, together with any required reports and any written authorization for services that may have been received by the physician.

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