Get a Form or Publication: outpatient
Your search for "outpatient" returned 3 documents.
See also
| Title | Type | Number |
|---|---|---|
| Massage Therapy Treatment Authorization Fax Request
Used by a licensed massage practitioner/clinic to request authorization for outpatient massage therapy services for L&I claims. |
Form | F248-357-000 |
| Occupational or Physical Therapy Treatment Authorization Fax Request
Used by a therapy provider/clinic to request authorization for outpatient occupational or physical therapy services for L&I claims. |
Form | F248-055-000 |
| UB04 HCFA 1450
Used by hospitals to bill L&I for inpatient/outpatient services. This version includes NPI number. |
Form | F245-367-000 |
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