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
30580 1,263.87 1,023.68
30600 1,158.16 903.48
30620 1,246.78 1,246.78
30630 1,273.05 1,273.05
30801 435.43 266.15
30802 567.57 383.04
30901 211.32 135.07
30903 386.20 176.51
30905 480.75 225.31
30906 549.64 291.91
30915 1,188.84 1,188.84
30920 1,717.47 1,717.47
30930 247.44 247.44
30999 BR 0.00 0.00
31000 348.67 212.94
31002 403.83 403.83
31020 939.07 701.92
31030 NRC 1,370.05 1,054.37
31032 NRC 1,161.15 1,161.15
31040 1,543.99 1,543.99
31050 995.82 995.82
31051 NRC 1,305.98 1,305.98
31070 878.72 878.72
31075 1,602.47 1,602.47
31080 2,078.59 2,078.59
31081 2,754.21 2,754.21
31084 2,412.65 2,412.65
31085 2,884.04 2,884.04
31086 2,303.15 2,303.15
31087 2,256.69 2,256.69
31090 2,051.75 2,051.75
31200 1,092.86 1,092.86
31201 1,491.85 1,491.85
31205 1,785.86 1,785.86
31225 3,857.05 3,857.05
31230 4,319.70 4,319.70
31231 NRC 371.81 160.60
31233 NRC 528.41 292.79
31235 NRC 604.32 347.35
31237 NRC 654.18 389.58
31238 675.99 423.59
31239 NRC 1,397.05 1,397.05
31240 NRC 345.95 345.95
31254 592.15 592.15
31255 870.06 870.06
31256 426.73 426.73
31267 NRC 688.96 688.96
31276 1,099.84 1,099.84
31287 503.18 503.18
31288 583.56 583.56
31290 2,480.06 2,480.06
31291 2,626.34 2,626.34
31292 2,130.55 2,130.55
CPT only © 2010 Americal Medical
Association. All rights reserved.
2010 Professional Provider Medical Services Fee Schedule
Effective 1-01-2011 Fees - Page 42 of 280