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Fee Schedules

Effective July 1, 2009.

This site contains the policies, payment methods, billing codes, and maximum fees used to pay health care and vocational providers who treat injured workers.

Make sure to check the Updates & Corrections tab for any changes to the Fee schedules. Read about the highlights of changes in the last year. These changes are also included in the payment policies.

Quick Reference to frequently used codes (F245-387-000) (40 KB PDF)

Professional and Facility Services Fee Schedules (July 2009)
Item		Excel
Professional Services Fee Schedule - Excel spreadsheet of the complete fee schedule excluding the ASC Fees, AP-DRGs, Hospital Rates and Residential Facility Rates.		5,231 KB
Item	PDF
Anesthesia - CPT ™ 00100 - 01999	141 KB
Evaluation and Management - CPT ™ 99201 - 99499	180 KB
Surgery - CPT ™ 10021 - 69990	1,592 KB
Radiology - CPT ™ 70010 - 79999	777 KB
Pathology and Laboratory - CPT ™ 80047 - 89356	504 KB
Medicine - CPT ™ 90281 - 99607	541 KB
CPT ™ Category II and III - CPT ™ 0001F - 0192T	262 KB
HCPCS - HCPCS A0021 - V5364	1,788 KB
Hospital Only Codes - C1300 - S0093	239 KB
Local Codes by Code - 0401A - 5093V, R0310 - R0392, & V0028	121 KB
Local Codes by Specialty - 0401A - 5093V, R0310 - R0392, & V0028	204 KB
ASC Fee Schedules - All approved codes	442 KB
AP-DRG Assignment - Version 23	112 KB
Hospital Rates	100 KB
Residential Facility Rates	58 KB

Fee Schedules - Comma delimited version		Field Key
Complete fee schedule excluding the ASC Fees, AP-DRGs, Hospital Rates and Residential Facility Rates.	1,512 KB	10 KB
Anesthesia	7 KB	7 KB
Ambulatory Surgery Center	177 KB	66 KB
AP-DRG	48 KB	38 KB
Hospital	13 KB	41 KB