Compensation 2010 Professional Provider Medical Services Fee ...

Ohio Bureau of Workers Compensation
2010 Professional Provider Medical Services Fee Schedule
CPT MOD DESCRIPTION
COVERAGE
FLAG
NON-FAC
FEE
FACILITY
FEE
21800 201.60 205.41
21805 538.63 538.63
21810 1,061.90 1,061.90
21820 268.68 272.50
21825 1,200.39 1,200.39
21899 BR 0.00 0.00
21920 NRC 511.52 333.09
21925 NRC 860.28 706.25
21930 NRC 937.37 759.70
21931 NRC 1,013.09 1,013.09
21932 NRC 1,455.05 1,455.05
21933 NRC 1,606.38 1,606.38
21935 NRC 2,189.45 2,189.45
21936 NRC 3,116.57 3,116.57
22010 1,942.07 1,942.07
22015 1,918.54 1,918.54
22100 1,804.88 1,804.88
22101 1,829.72 1,829.72
22102 1,704.90 1,704.90
22103 312.49 312.49
22110 2,228.97 2,228.97
22112 2,213.37 2,213.37
22114 2,065.87 2,065.87
22116 305.69 305.69
22206 4,971.97 4,971.97
22207 5,056.23 5,056.23
22208 1,271.81 1,271.81
22210 3,707.90 3,707.90
22212 3,065.24 3,065.24
22214 3,091.29 3,091.29
22216 796.36 796.36
22220 3,370.27 3,370.27
22222 3,069.22 3,069.22
22224 3,301.00 3,301.00
22226 798.19 798.19
22305 375.39 347.17
22310 607.25 569.89
22315 1,769.62 1,584.33
22318 3,426.51 3,426.51
22319 3,809.25 3,809.25
22325 2,983.31 2,983.31
22326 3,105.41 3,105.41
22327 3,068.69 3,068.69
22328 618.39 618.39
22505 246.16 246.16
22520 4,389.94 1,140.82
22521 4,290.63 1,077.35
22522 505.69 505.69
22523 1,260.33 1,260.33
22524 1,209.88 1,209.88
22525 570.49 570.49
22526 3,898.71 688.48
22527 3,069.40 311.35
CPT only © 2010 Americal Medical
Association. All rights reserved.
2010 Professional Provider Medical Services Fee Schedule
Effective 1-01-2011 Fees - Page 16 of 280