Compensation 2010 Professional Provider Medical Services Fee ...
Compensation 2010 Professional Provider Medical Services Fee ...
Compensation 2010 Professional Provider Medical Services Fee ...
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Ohio Bureau of Workers <strong>Compensation</strong><br />
<strong>2010</strong> <strong>Professional</strong> <strong>Provider</strong> <strong>Medical</strong> <strong>Services</strong> <strong>Fee</strong> Schedule<br />
CPT MOD DESCRIPTION<br />
COVERAGE<br />
FLAG<br />
NON-FAC<br />
FEE<br />
FACILITY<br />
FEE<br />
13120 655.07 508.66<br />
13121 888.44 677.22<br />
13122 243.75 182.75<br />
13131 725.36 575.14<br />
13132 1,177.02 980.29<br />
13133 344.76 282.23<br />
13150 722.02 571.05<br />
13151 823.06 663.69<br />
13152 1,139.40 896.92<br />
13153 377.96 304.76<br />
13160 1,690.18 1,690.18<br />
14000 1,250.43 1,041.50<br />
14001 1,623.57 1,377.27<br />
14020 1,403.58 1,185.50<br />
14021 1,773.62 1,522.75<br />
14040 1,557.14 1,342.11<br />
14041 1,934.93 1,656.60<br />
14060 1,587.87 1,418.59<br />
14061 2,073.99 1,768.22<br />
14301 2,247.07 1,914.61<br />
14302 499.24 499.24<br />
14350 1,537.22 1,537.22<br />
15002 672.53 477.32<br />
15003 147.41 98.61<br />
15004 799.68 582.36<br />
15005 248.86 194.73<br />
15040 503.25 270.68<br />
15050 1,100.44 910.57<br />
15100 1,752.83 1,490.53<br />
15101 375.45 235.90<br />
15110 1,746.86 1,544.03<br />
15111 252.92 229.29<br />
15115 1,756.04 1,576.85<br />
15116 349.50 321.29<br />
15120 1,920.92 1,638.02<br />
15121 534.73 361.63<br />
15130 1,362.95 1,163.17<br />
15131 203.59 186.05<br />
15135 1,764.14 1,590.29<br />
15136 176.56 165.12<br />
15150 1,444.72 1,337.20<br />
15151 265.42 247.12<br />
15152 338.06 317.47<br />
15155 1,391.18 1,302.72<br />
15156 371.52 354.74<br />
15157 374.13 350.50<br />
15170 888.04 776.71<br />
15171 199.16 190.01<br />
15175 1,085.26 980.79<br />
15176 311.27 293.73<br />
15200 1,643.09 1,374.69<br />
15201 293.73 168.68<br />
15220 1,544.54 1,280.71<br />
CPT only © <strong>2010</strong> Americal <strong>Medical</strong><br />
Association. All rights reserved.<br />
<strong>2010</strong> <strong>Professional</strong> <strong>Provider</strong> <strong>Medical</strong> <strong>Services</strong> <strong>Fee</strong> Schedule<br />
Effective 1-01-2011 <strong>Fee</strong>s - Page 6 of 280
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