Article 5.3 - Official Medical Fee Schedule

Section 9789.10 - Physician Services Rendered on or After July 1, 2004, but Before January 1, 2014 - Definitions
Section 9789.11 - Physician Services Rendered on or After July 1, 2004, but Before January 1, 2014
Section 9789.12.1 - Physician Fee Schedule: Official Medical Fee Schedule for Physician and Non-Physician Practitioner Services - for Services Rendered on or After January 1, 2014
Section 9789.12.2 - Calculation of the Maximum Reasonable Fee - Services Other than Anesthesia
Section 9789.12.3 - Status Codes C, I, N and R
Section 9789.12.4 - "by Report" - Reimbursement for Unlisted Procedures/Procedures Lacking RBRVUs
Section 9789.12.5 - Conversion Factors
Section 9789.12.6 - Geographic Health Professional Shortage Area Bonus Payment: Primary Care; Mental Health
Section 9789.12.7 - CMS' National Physician Fee Schedule Relative Value File / Relative Value Units (RVUs)
Section 9789.12.8 - Status Codes
Section 9789.12.9 - Professional Component (PC)/Technical Component (TC) Indicator
Section 9789.12.10 - Coding; Current Procedural Terminology, Fourth Edition
Section 9789.12.11 - Evaluation and Management: Coding - New Patient; Established Patient; Documentation
Section 9789.12.12 - Consultation Services Coding - Use of Visit Codes
Section 9789.12.13 - Correct Coding Initiative
Section 9789.12.14 - California Specific Codes
Section 9789.12.15 - California Specific Modifier
Section 9789.13.1 - Supplies
Section 9789.13.2 - Physician-Administered Drugs, Biologicals, Vaccines, Blood Products
Section 9789.13.3 - Physician-Dispensed Drugs
Section 9789.14 - Reimbursement for Reports, Duplicate Reports, Chart Notes
Section 9789.15.1 - Non-Physician Practitioner (NPP) - Payment Methodology
Section 9789.15.2 - Non-Physician Practitioner (NPP) - "Incident to" Services
Section 9789.15.3 - Qualified Non-Physician Anesthetist Services
Section 9789.15.4 - Physical Medicine/Chiropractic/Acupuncture Multiple Procedure Payment Reduction; Pre-Authorization for Specified Procedure/Modality Services
Section 9789.15.5 - Ophthalmology Multiple Procedure Reduction
Section 9789.15.6 - Diagnostic Cardiovascular Procedures - Multiple Procedure Reduction
Section 9789.16.1 - Surgery - Global Fee
Section 9789.16.2 - Surgery - Billing Requirements for Global Surgeries
Section 9789.16.3 - Surgery - Global Fee - Miscellaneous Rules
Section 9789.16.4 - Surgery - Global Fee; Exception: Circumstances Allowing E and M Code During the Global Period; Primary Treating Physician's Progress Report (PR-2)
Section 9789.16.5 - Surgery - Multiple Surgeries and Endoscopies
Section 9789.16.6 - Surgery - Bilateral Surgeries
Section 9789.16.7 - Surgery - CO-Surgeons and Team Surgeons
Section 9789.16.8 - Surgery - Assistants-at-Surgery
Section 9789.17.1 - Radiology Diagnostic Imaging Multiple Procedures
Section 9789.17.2 - Radiology Consultations
Section 9789.17.3 - Additional Payment Reductions for Certain Diagnostic Imaging Services
Section 9789.18.1 - Payment for Anesthesia Services - General Payment Rule
Section 9789.18.2 - Anesthesia - Personally Performed Rate
Section 9789.18.3 - Anesthesia - Medically Directed Rate
Section 9789.18.4 - Anesthesia - Definition of Concurrent Medically Directed Anesthesia Procedures
Section 9789.18.5 - Anesthesia - Medically Supervised Rate
Section 9789.18.6 - Anesthesia - Multiple Anesthesia Procedures
Section 9789.18.7 - Anesthesia - Medical and Surgical Services Furnished in Addition to Anesthesia Procedure
Section 9789.18.8 - Anesthesia - Time and Calculation of Anesthesia Time Units
Section 9789.18.9 - Anesthesia - Base Unit Reduction for Concurrent Medically Directed Procedures
Section 9789.18.10 - Anesthesia - Monitored Anesthesia Care
Section 9789.18.11 - Anesthesia Claims Modifiers
Section 9789.18.12 - Anesthesia and Medical/Surgical Service Provided by the Same Physician
Section 9789.19 - Update Table
Section 9789.19.1 - Table A
Section 9789.20 - General Information for Inpatient Hospital Fee Schedule - Discharge on or After July 1, 2004
Section 9789.21 - Definitions for Inpatient Hospital Fee Schedule
Section 9789.22 - Payment of Inpatient Hospital Services
Section 9789.23 - Hospital Cost to Charge Ratios, Hospital Specific Outliers, and Hospital Composite Factors
Section 9789.24 - Diagnostic Related Groups, Relative Weights, Geometric Mean Length of Stay
Section 9789.25 - Federal Regulations, Federal Register Notices, and Payment Impact File by Date of Discharge
Section 9789.30 - Hospital Outpatient Departments and Ambulatory Surgical Centers - Definitions
Section 9789.31 - Hospital Outpatient Departments and Ambulatory Surgical Centers-Adoption of Standards
Section 9789.32 - Outpatient Hospital Departments and Ambulatory Surgical Centers Fee Schedule - Applicability
Section 9789.33 - Hospital Outpatient Departments and Ambulatory Surgical Centers Fee Schedule - Determination of Maximum Reasonable Fee
Section 9789.34 - Table A
Section 9789.35 - Table B
Section 9789.36 - Update of Rules to Reflect Changes in the Medicare Payment System
Section 9789.37 - DWC Form 15 Election for High Cost Outlier
Section 9789.38 - Appendix X
Section 9789.39 - Update Table by Date of Service
Section 9789.40 - Pharmacy
Section 9789.50 - Pathology and Laboratory
Section 9789.60 - Durable Medical Equipment, Prosthetics, Orthotics, Supplies
Section 9789.70 - Ambulance Services
Section 9789.80 - Skilled Nursing Facility. [Reserved]
Section 9789.90 - Home Health Care. [Reserved]
Section 9789.100 - Outpatient Renal Dialysis. [Reserved]
Section 9789.110 - Update of Rules to Reflect Changes in the Medicare Payment System
Section 9789.111 - Effective Date of Fee Schedule Provisions