2024 Fee Schedules

Effective July 1, 2024

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.

2024 Quick Reference Fee Schedule (English) Español (Spanish)

Professional and Facility Services Fee Schedules (July 2024)

Note: These fee schedules have been enhanced with search features for your convenience. Enable Macros in Excel for the files below to open without errors. These files are best viewed in the desktop application and not the web browser.

• Professional Services Fee Schedule — Excel spreadsheet of the complete fee schedule excluding the ASC Fees, AP-DRGs, Hospital Rates and Residential Facility Rates. This fee schedule has been enhanced with a search feature for your convenience.

Note: For your reference here are the code ranges you will find in the professional fee schedule.

• • Evaluation and Management — CPT™ 99202 - 99499
  • Surgery — CPT™ 10004 - 69979
  • Radiology — CPT™ 70010 - 79999
  • Pathology and Laboratory — CPT™ 80047 - 89398 and 0001U - 0222U
  • Medicine — CPT™ 90281 - 99607
  • CPT ™ Category II and III — CPT™ 0001F - 0639T
  • HCPCS — A0021 - V5364
  • Medical and Surgical Supplies Codes — HCPCS A4206 - A9999 (For DME Providers)
  • Facility Only Codes — C1300 - S0093
  • Local Codes — Local Codes Listed by Specialty                                                            

• Anesthesia  — CPT™ 00100 - 01999
• ASC Fee Schedules  — All approved codes
• APR-DRG Assignment  — Version 38
• Hospital Rates
• Residential Facility Rates

Fee Schedules - Comma delimited version with Field Key

• Complete fee schedule  excluding the ASC Fees, AP-DRGs, Hospital Rates and Residential Facility Rates, Field Key
• Anesthesia
• Ambulatory Surgery Center  Field Key
• APR-DRG  Field Key
• Hospital  Field Key

2024 Billing & Payment Policies

Effective July 1, 2024

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 Complete   (2024)

• Chapter 1 - Introduction
• Chapter 2 - Information for All Providers

Professional Services

• Chapter 3 - Ambulance Services
• Chapter 4 - Anesthesia Services
• Chapter 5 - Audiology and Hearing Services
• Chapter 6 - Biofeedback, Electrocardiograms (EKG), Electrodiagnostic services, and Extracorporeal shockwave therapy (ESWT)
• Chapter 7 - Chiropractic Services
• Chapter 8 - Dental Services
• Chapter 9 - Durable Medical Equipment (DME)
• Chapter 10 - Evaluation and Management (E/M) Services
• Chapter 11 - Home Health Services
• Chapter 12 - Impairment Rating Services
• Chapter 13 - Independent Medical Exams (IME)
• Chapter 14 - Language Access Services
• Chapter 15 - Medical Testimony
• Chapter 16 - Medication Administration and Injections
• Chapter 17 - Mental Health Services
• Chapter 18 - Modifications: Home, Job, and Vehicle
• Chapter 19 - Naturopathic Physicians and Acupuncture Services
• Chapter 20 - Nurse Case Management
• Chapter 21 - Obesity Treatment
• Chapter 22 - Other Services
• Chapter 23 - Pathology and Laboratory Services
• Chapter 24 - Pharmacy Services
• Chapter 25 - Physical Medicine Services
• Chapter 26 - Radiology Services
• Chapter 27 - Reports and Forms
• Chapter 28 - Supplies, Materials, and Bundled Services
• Chapter 29 - Surgery Services
• Chapter 30 - Vocational Services
• Chapter 31 - Washington RBRVS Payment System

Facility Services

• Chapter 32 - Ambulatory Surgery Centers (ASCs)
• Chapter 33 - Brain Injury Rehabilitation Services
• Chapter 34 - Chronic Pain Management
• Chapter 35 - Hospitals
• Chapter 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.

2024 Updates and Corrections

Updates

Payment policy updates

Fee schedule updates

Corrections

Payment policy corrections

Fee schedule corrections