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Allan L. McVey
Insurance Commissioner
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Workers' Compensation Schedule Of Maximum Allowed Medical Reimbursement
Effective: July 1, 2013 Methodology will remain in effect until further notice.
HOWEVER, codes become valid for payment upon national release dates and should be updated at that time for proper reimbursement. Codes should NOT be held / denied from date of release until the upcoming July.
Provider Fees: The fee schedule serves as a "maximum allowable" and is applied to all workers' compensation medical care except for care provided under an OIC approved Managed Health Care Plan (MHCP).
Approved MHCP’s are exempt from the maximum fee schedule.
Please consult individual payor for further guidance for the following:
Codes listed with "0";
Codes not listed; or
Issues not addressed by WV law, rule or methodology.
Disclaimer: The absence or presence of a code does not indicate workers' compensation coverage.
(Revised November 22, 2013)
Links
Ambulatory Surgical Center
Clinical Labs
RBRVS-Based Procedures
HCPCS Level II
Biological and Injectables
Anesthesia
Hospital Inpatient Services
Hospital Outpatient Serives
Out-of-State Health Care Services
Pharmacy Services
Expert Witness - (Code 99075) See WV 85 CSR Series 1 (§85-1-17)
Travel Expenses
Funeral Expense