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
24930 1,577.73 1,577.73
24931 1,641.45 1,641.45
24935 2,222.45 2,222.45
24940 1,604.08 1,604.08
24999 BR 0.00 0.00
25000 692.62 692.62
25001 672.38 672.38
25020 1,151.65 1,151.65
25023 2,268.15 2,268.15
25024 1,604.86 1,604.86
25025 2,518.83 2,518.83
25028 1,035.70 1,035.70
25031 757.85 757.85
25035 1,282.47 1,282.47
25040 1,164.99 1,164.99
25065 NRC 497.39 338.78
25066 NRC 754.40 754.40
25071 NRC 912.73 912.73
25073 NRC 1,134.20 1,134.20
25075 NRC 744.50 675.11
25076 NRC 1,061.66 1,061.66
25077 NRC 1,836.66 1,836.66
25078 NRC 2,447.21 2,447.21
25085 939.11 939.11
25100 NRC 700.65 700.65
25101 822.30 822.30
25105 998.14 998.14
25107 1,257.83 1,257.83
25109 1,079.14 1,079.14
25110 719.35 719.35
25111 638.08 638.08
25112 779.48 779.48
25115 1,630.56 1,630.56
25116 1,301.23 1,301.23
25118 775.67 775.67
25119 1,031.09 1,031.09
25120 1,099.04 1,099.04
25125 1,299.72 1,299.72
25126 1,303.95 1,303.95
25130 914.70 914.70
25135 1,156.59 1,156.59
25136 1,009.33 1,009.33
25145 1,136.58 1,136.58
25150 1,176.85 1,176.85
25151 1,286.79 1,286.79
25170 NRC 2,912.22 2,912.22
25210 1,001.05 1,001.05
25215 1,283.35 1,283.35
25230 881.02 881.02
25240 888.69 888.69
25246 341.00 165.62
25248 890.81 890.81
25250 1,076.11 1,076.11
CPT only © 2010 Americal Medical
Association. All rights reserved.
2010 Professional Provider Medical Services Fee Schedule
Effective 1-01-2011 Fees - Page 22 of 280