Statutes, codes, and regulations
Pennsylvania Code (Rules and Regulations)
Title 34 - LABOR AND INDUSTRYPart VIII - Bureau of Workers' CompensationChapter 127 - WORKERS' COMPENSATION MEDICAL COST CONTAINMENTSubchapter B - MEDICAL FEES AND FEE REVIEW
CALCULATIONS
Section 127.109 - Supplies and services not covered by fee schedule

34 Pa. Code § 127.109

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Current through Register Vol. 54, No. 49, December 7, 2024
Section 127.109 - Supplies and services not covered by fee schedule

Payments for supplies provided over those included with the billed office visit shall be made at 80% of the provider's usual and customary charge when the provider supplies sufficient documentation to support the necessity of those supplies. Supplies included in the office visit code by Medicare may not be fragmented or unbundled in accordance with § 127.204 (relating to fragmenting or unbundling of charges by providers).

34 Pa. Code § 127.109

This section cited in 34 Pa. Code § 127.101 (relating to medical fee caps-Medicare).