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Work Comp Fees

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)

2008 WORKERS COMPENSATION FEE SCHEDULE
REVISED & EFFECTIVE    JULY 1, 2008

CPT CODE DESCRIPTION 2008 RVU 2008 CF 2008 MAX FEE
E/M New Patient Type / Complexity

Time=

RVU’s 2008 CF 2008  
99201 Problem Focused /straight forward =

10 minutes

1.0 64.79 64.79
99202 Expanded / straight forward complexity=

20 minutes

1.74 64.79 112.73
99203 Detailed / low complexity = 30 min 2.55 64.79 165.21
99204 Comprehensive / moderate complexity = 45 min 3.91 64.79 253.33
99205 Comprehensive / High complexity = 60 min 4.93 64.79 319.41
         
E/M Estab Patient     CF 2008  
99211 Problem  = 5 min .54 64.79 34.99
99212 Expanded = 10 min 1.03 64.79 66.73
99213 Detailed = 15 min 1.67 64.79 108.20
99214 Comprehensive =

25 minutes

2.53 64.79 163.92
99215 Comprehensive =

40 minutes

3.43 64.79 222.23
         
Chiro CMT= Adjustments     CF= same in 2008  
98940 Adj= 1-2 regions .68 75.04 51.03
98941 Adj= 3-4 regions .95 75.04 71.29
98942 Adj= 5 regions 1.24 75.04 93.05
98943 Extremity Adjustment .62 75.04 46.52
         
Physiotherapies attended & unattended   CF= same in 2008  
97010 Hot or Cold Packs .13 65.79 8.55
97012 Traction / mechanical .39 65.79 25.66
97014 Elect Stim(unattended) .37 65.79 24.34
97016 Vasopneumatic Tx .39 65.79 25.66
97032 Elect Stim (attended) .44 65.79 28.95 = 15 min
97035 Ultrasound .32 65.79 21.05= 15 min
97110 Therapeutic Exercises .76 65.79 50.00 = 15 min
97124 Massage Therapy .61 65.79 40.13= 15 min
97140 Myofascial Release .71 65.79 46.71 = 15 min
         
Radiology TC= Technical Component (Taking) RVU CF= 2008 2008 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 06/08 as WCD Admin Order 07-051}