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In 2005, legislation passed a bill that required physicians to accept the Oregon Workers' Compensation Fee schedule on automobile accident (P.I.P.) claims. The fee schedule is comprised using three identifiers which are:
1: CPT Code
2: Relative Value Unit (RVU)
3: Conversion Factor (CF)
2007 WORKERS COMPENSATION FEE SCHEDULE
REVISED & EFFECTIVE JULY 1, 2007
| CPT CODE | DESCRIPTION | 2007 RVU | 2007 CF | 2007 MAX FEE |
| E/M New Patient | Type / Complexity
Time= |
RVU’s= some increased in 2007 | CF= E/M decreased in 2007 | |
| 99201 | Problem Focused /straight
forward =
10 minutes |
.99 | 59.79 | 59.19 |
| 99202 | Expanded / straight forward
complexity=
20 minutes |
1.73 | 59.79 | 103.44 |
| 99203 | Detailed / low complexity = 30 min | 2.56 | 59.79 | 153.06 |
| 99204 | Comprehensive / moderate complexity = 45 min | 3.92 | 59.79 | 234.38 |
| 99205 | Comprehensive / High complexity = 60 min | 4.93 | 59.79 | 294.76 |
| E/M Estab Patient | CF= decreased in 2007 | |||
| 99211 | Problem = 5 min | .55 | 59.79 | 32.88 |
| 99212 | Expanded = 10 min | 1.02 | 59.79 | 60.99 |
| 99213 | Detailed = 15 min | 1.66 | 59.79 | 99.25 |
| 99214 | Comprehensive =
25 minutes |
2.52 | 59.79 | 150.67 |
| 99215 | Comprehensive =
40 minutes |
3.42 | 59.79 | 204.48 |
| Chiro CMT= Adjustments | CF= same in 2007 | |||
| 98940 | Adj= 1-2 regions | .69 | 75.04 | 51.78 |
| 98941 | Adj= 3-4 regions | .95 | 75.04 | 71.29 |
| 98942 | Adj= 5 regions | 1.25 | 75.04 | 93.80 |
| 98943 | Extremity Adjustment | .63 | 75.04 | 47.28 |
| Physiotherapies | attended & unattended | CF= same in 2007 | ||
| 97010 | Hot or Cold Packs | .13 | 65.79 | 8.55 |
| 97012 | Traction / mechanical | .39 | 65.79 | 25.66 |
| 97014 | Elect Stim(unattended) | .38 | 65.79 | 25.00 |
| 97016 | Vasopneumatic Tx | .39 | 65.79 | 25.66 |
| 97032 | Elect Stim (attended) | .43 | 65.79 | 28.28 = 15 min |
| 97035 | Ultrasound | .32 | 65.79 | 21.05= 15 min |
| 97110 | Therapeutic Exercises | .75 | 65.79 | 49.34 = 15 min |
| 97124 | Massage Therapy | .60 | 65.79 | 39.47= 15 min |
| 97140 | Myofascial Release | .70 | 65.79 | 46.05 = 15 min |
| Radiology | TC= Technical Component (Taking) | RVU | CF= 2007 | 2007 Max Fee |
| 72050 TC | 5 views Cervical | .96 | 68.00 | 65.28 |
| 72052 TC | 7 views Cervical | 1.21 | 68.00 | 82.28 |
| 72070 TC | 2 views Thoracic | .66 | 68.00 | 44.88 |
| 72100 TC | 2 views Lumbar | .72 | 68.00 | 48.96 |
| Both TC & PC (below) | ||||
| 72050 | 5 views Cervical | 1.38 | 68.00 | 93.84 |
| 72052 | 7 views Cervical | 1.71 | 68.00 | 116.28 |
| 72070 | 2 views Thoracic | .96 | 68.00 | 65.28 |
| 72100 | 2 views Lumbar | 1.02 | 68.00 | 69.36 |
| PC= Prof Component / (Reading xray) |
CPT CODE = BILLING CODE (AMA)
RVU= RELATIVE VALUE UNIT CF= CONVERSION FACTOR
MAX FEE= RVU x CF = Maximum Allowable Fee (Work Comp- Fee Schedule)
{ORS= 436-009-0050 Amended 5/22/07 as WCD Admin Order 07-051}