Minnesota Administrative Rules
Agency 151 - Labor and Industry Department
Chapter 5221 - FEES FOR MEDICAL SERVICES
Part 5221.4005 - INSTRUCTIONS FOR APPLICATION OF FEE SCHEDULE
Universal Citation: MN Rules 5221.4005
Current through Register Vol. 49, No. 13, September 23, 2024
Subpart 1. Workers' compensation medical fee schedule; incorporation of Medicare National Physician Relative Value Files.
The workers' compensation medical fee schedule consists of items A and B:
A. the tables in the
Medicare National Physician Fee Schedule Relative Value File and the Geographic
Practice Cost Indices File most recently incorporated by reference by the
commissioner by publishing in the State Register pursuant to Minnesota
Statutes, section
176.136,
subdivision 1a; and
B. parts
5221.4005 to
5221.4061, which contain
instructions for applying the Medicare Physician Fee Schedule tables described
in item A to determine the maximum fees for treatment of injured workers under
Minnesota Statutes, section
176.136.
Subp. 2. Effective date.
The medical fee schedule applies to treatment provided on or after the effective date of:
A. the
most recent fee schedule tables adopted pursuant to Minnesota Statutes, section
176.136,
subdivision 1a, as described in subpart
1; and
B. corresponding rules in parts
5221.4005 to
5221.4061 to implement the fee
schedule tables.
Subp. 3. Applicability.
The medical fee schedule applies to a charge for a particular health care service if:
A. the medical
service is compensable under Minnesota Statutes, section
176.135;
B. the service conforms to a CPT, HCPCS, or
revenue billing code in effect on the date the service was rendered;
and
C. the billing code for the
service is listed under the appropriate provider group designation for the
health care provider that rendered the service.
Statutory Authority: MS s 14.38; 14.386; 14.388
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