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
36415 3.75 3.75
36416 3.75 3.75
36420 NRC 110.77 110.77
36425 86.98 86.98
36430 70.36 70.36
36440 NRC 122.65 122.65
36450 NRC 247.48 247.48
36455 274.40 274.40
36460 NRC 779.46 779.46
36468 NRC 0.00 0.00
36469 NRC 0.00 0.00
36470 NRC 294.00 156.74
36471 NRC 365.12 221.77
36475 NRC 3,692.15 806.76
36476 NRC 826.85 396.78
36478 NRC 2,990.67 804.51
36479 NRC 853.24 394.20
36481 1,708.92 799.99
36500 414.01 414.01
36510 NRC 228.81 134.26
36511 207.45 207.45
36512 201.18 201.18
36513 216.14 216.14
36514 1,046.99 204.40
36515 3,874.77 200.16
36516 4,298.95 154.63
36522 NRC 2,714.26 219.28
36555 NRC 556.99 274.86
36556 488.57 269.73
36557 NRC 1,834.96 692.70
36558 1,663.68 626.65
36560 NRC 2,271.90 757.52
36561 2,389.81 780.12
36563 2,461.42 812.84
36565 2,046.59 782.32
36566 8,106.60 833.65
36568 NRC 621.29 213.34
36569 540.18 208.48
36570 NRC 2,331.05 670.28
36571 2,542.10 700.60
36575 323.65 78.88
36576 773.58 428.16
36578 1,053.09 479.68
36580 464.55 151.15
36581 1,551.65 446.76
36582 2,214.86 682.18
36583 2,346.37 711.52
36584 448.90 149.99
36585 2,229.39 625.80
36589 359.93 308.84
36590 595.00 444.02
36591 45.96 45.96
36592 50.54 50.54
CPT only © 2010 Americal Medical
Association. All rights reserved.
2010 Professional Provider Medical Services Fee Schedule
Effective 1-01-2011 Fees - Page 56 of 280