Pennsylvania Code
Title 34 - LABOR AND INDUSTRY
Part VIII - Bureau of Workers' Compensation
Chapter 127 - WORKERS' COMPENSATION MEDICAL COST CONTAINMENT
Subchapter B - MEDICAL FEES AND FEE REVIEW
CALCULATIONS
Section 127.130 - Special reports
Universal Citation: 34 PA Code ยง 127.130
Current through Register Vol. 54, No. 38, September 21, 2024
(a) Payments shall be made for special reports (CPT code 99080) only if these reports are specifically requested by the insurer. Office notes and other documentation which are necessary to support provider codes billed may not be considered special reports.
(b) Payments for special reports shall be at 80% of the provider's usual and customary charge.
(c) The Bureau-prescribed report required by § 127.203 (relating to medical bills-submission of medical reports) may not be considered a special report that is chargeable under this section.
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