Professional Reimbursement Schedules Effective 7/1/07

Allied Practitioner Schedules

Allied Practitioner Schedules will apply to Chiropractors, CRNAs, Occupational Therapists, Audiologists, Physical Therapists, Speech Pathologists, Optometrists, Oral Pathologists.

  • Assistant Surgery allowable is 20% of the Surgery rate.

  • Physician Assistants, Advance Nurse Practitioners, Registered Nurse First Assistants, Licensed Surgical Assistants, Clinical Nurse Specialists and Nurse Midwives will be reimbursed 85% of the rates posted on the internet except for Drugs, Clinical Lab, Durable Medical Equipment/Prosthetics and Orthotics. Drugs, Clinical Lab, Durable Medical Equipment/ Prosthetics and Orthotics will be reimbursed at 100% of the rates posted on the internet.

All Other Reimbursement Schedules

All Other Reimbursement Schedules will apply to the
following specialties:

MDs, DOs, DPMs, Psychiatrists, Psychologists, Licensed Professional Counselors, Licensed Psychological Associates, Licensed Marriage and Family Therapists, Licensed Chemical Dependency Counselors, Social Workers, Pathologists, Radiologists, and Nuclear Medicine.

  • Assistant Surgery allowable is 20% of the Surgery rate.

  • Physician Assistants, Advance Nurse Practitioners, Registered Nurse First Assistants, Licensed Surgical Assistants, Clinical Nurse Specialists and Nurse Midwives will be reimbursed 85% of the rates posted on the internet except for Drugs, Clinical Lab, Durable Medical Equipment/Prosthetics and Orthotics. Drugs, Clinical Lab, Durable Medical Equipment/ Prosthetics and Orthotics will be reimbursed at 100% of the rates posted on the internet.