2018 MARFS

Updates and Corrections

On this page, view the following:

Updates

Payment policy updates
Payment Policy Updates
Posting date Policy Area Description
08/30/19 Home Health Services Two errors were made in Chapter 11: Home Health Services. The correct pricing for G0300 is $37.80 and for S9124 it is $44.38.
5/7/2019 Chapter 14: Interpreter Services Effective 5/7/2019, video remote interpreting is not available
4/1/2019 Chapter 25: Physical Medicine Services Effective: 4/25/2019, the attached policy is appended to the Physical Medicine Services chapter of MARFS. This policy allows supervised PT and OT students to assist with L&I claims. Please see the attached PDF.
11/30/2018 Chapter 18: Modifications: Home, Job and Vehicle; Chapter 30: Vocational Services

Effective 1/1/2019, L&I has made significant changes to Medical Aid Rules and Fee Schedules Chapter 30: Vocational Services. Please see the PDF of Chapter 30 in this table.

Effective 01/01/2019, the payment policy for job modifications and pre-job modifications is being removed from Chapter 18: Modifications: Home, Job and Vehicle and can now be found in the updated Chapter 30: Vocational Services.  Please see the PDF of Chapter 30 in this table.
Chapter 18: Modifications: Home and Vehicle (Revised)
Chapter 30: Vocational Services (Revised)

 


Fee schedules updates
Fee Schedule Updates
Posting date Description Updated Version
6/3/2019

The following codes are payable effective 01/01/2019

Code Facility Fee Non-Facility Fee
96136 $88.69 $45.97
96137 $82.22 $35.61
Effective 01/01/2019
4/29/2019 An error occurred on the 2018 fee schedule, the maximum fee for one unit of 1045M is $255.48 and the maximum fee for 1098M is $128.21.  
12/13/2018 Professional Fee Schedule Updates: New CPT and HCPCS effective January 1, 2019. Adobe PDF file New CPT & HCPCS effective
January 1, 2019
12/13/2018 Ambulatory Surgery Center Fee Schedule Updates: New codes effective January 1, 2019 and deleted codes effective December 31, 2018. Adobe PDF file New ASC codes effective
January 1, 2019 and deleted codes effective December 31, 2018
12/12/2018 DELETED Procedure Codes – Invalid after December 31, 2018 Adobe PDF file January 2019 Deleted Codes
9/4/2018

Q5108 is covered effective October 1, 2018.  The code is paid ‘By Report’ and does not require prior authorization. 

N/A
9/21/2018 1097M - Review of Physical Capacities Evaluation Report (review) was added to the fee schedule effective 07/01/2018.  This code should be used to bill the department when a provider reviews the a Physical Capacities Evaluation rather than 1038M N/A
9/21/2018 1729M - PGAP Coach Mileage was added to the fee schedule effective 11/21/2017 and is payable at the State Rate for mileage. N/A
9/21/2018 1728M – PGAP Coach Travel Time was added to the fee schedule effective 11/21/2017 and has a non-facility fee of $7.08 and a facility fee of $6.96. N/A
9/21/2018 Errors were found on the fee schedule and are being corrected as follows:

Codes 27412, 81539, J7330 is not covered
Codes 28800, 28805, 29844, 29845, 47544 require Utilization review.
Code 2014M has a non-facility fee of $1.60 and a facility fee of $1.60

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Corrections

Payment policies corrections
Payment Policy Corrections
Posting Date Policy Area Description
10/18/2019 Chapter 27: Reports and Forms An error occurred in the payment policy, the maximum fee for S9982 is $0.54.
08/07/2019 Chapter 10: Evaluation and Management An error occurred in the payment policy, the maximum non-facility fee for 98969 is $46.97.

Fee schedule corrections
Fee Schedules Corrections
Posting Date Description Updated Version
8/30/19 An error was found on the fee schedule. The correct fee for 90371 is $180.14.  
4/12/2019
  • 96138 and 96139 are covered effective 01/01/2019.  Both codes have a maximum facility and non-facility fee of $73.16.
  • Errors were found on the 2018 fee schedule and are being corrected as follows:
    • E0935 has a maximum facility and non facility fee of $25.32 per day.
    • E0936 is priced by report.
 
12/14/2018

Errors were found on the 2018 fee schedule and are being corrected as follows:
1001M has a maximum fee of $127.08.
2050A has a maximum fee of $44.73.

N/A

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