Carlos Posted Wed 03rd of January, 2018 09:33:08 AM
What is the fee schedule in Florida for CPT 99456 Independent Medical Examination for a worker comp case?
SuperCoder Answered Thu 04th of January, 2018 02:45:19 AM
Each state has its own WC regulations. You should check with your state workers compensation carriers before you code. IME services are reimbursed at either the MRA or a mutually agreed upon contract amount.
In fee schedule, code 99456 has a code status of “R”, which means that the coverage for this code is restricted and the service is carrier priced. Reimbursement is determined by the carrier and the payment is based on a provider’s documentation containing information on complete description of the procedure performed, medical necessity, and cost of any additional supplies etc.