2018 MARFS

Billing & Payment Policies

Effective July 1, 2018

 

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These billing and payment policies determine under what conditions we will pay health care and vocational providers who treat injured workers and crime victims.

Note: Make sure to check the Updates & Corrections tab for any changes to the Payment policies.

Payment Policies PDF fileComplete (4.88 MB PDF)
Chapter # Title
1
Introduction
2
Information for All Providers
Professional Services
3
Ambulance, Taxi and Other Transportation Services
4
Anesthesia Services
5
Audiology and Hearing Services
6
Biofeedback, Electrodcardiograms (EKG), Electrodiagnostic services, and Extracorporeal shockwave therapy (ESWT)
7
Chiropractic Services
8
Dental Services
9
Durable Medical Equipment (DME)
10
Evaluation and Management (E/M) Services
11
Home Health Services
12
Impairment Rating Services
13
Independent Medical Exams (IME)
14
Interpretive Services
15
Medical Testimony
16
Medication Administration and Injections
17
Mental Health Services
18
Modifications: Home, Job, and Vehicle
Modifications: Home, Job, and Vehicle (Revised, Effective 01/01/2019)
19
Naturopathic Physicians
20
Nurse Case Management
21
Obesity Treatment
22
Other Services
23
Pathology and Laboratory Services
24
Pharmacy Services
25
Physical Medicine Services
26
Radiology Services
27
Reports and Forms
28
Supplies, Materials, and Bundled Services
29
Surgery Services
30
Vocational Services
Vocational Services (Revised, Effective 01/01/2019)
31
Washington RBRVS Payment System
Facility Services
32
Ambulatory Surgery Centers (ASCs)
33
Brain Injury Rehabilitation Services
34
Chronic Pain Management
35
Hospitals
36
Nursing Home and Other Residential Care Services

Unless noted, all policies in the Medical Aid Rules and Fee Schedules apply to claimants receiving benefits from either the State Fund, the Crime Victims Compensation Program or Self-Insurers.

Providers must follow the administrative rules, medical coverage decisions and payment policies applicable to L&I. You can find this information in the Medical Aid Rules and Fee Schedules, Provider Bulletins and Provider Updates.

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