Resources for California Worker's Compensation Billing

Monday, January 04, 2010
Posted in: Practice Management

In a recent post, I put out a link to a document by the California Academy of Family Physicians with great guidelines for how to get paid for medical billing.  (Click here for that.)   We also have many users in California who are looking for guidelines and/or resources to bill within the California Worker’s Compensation system.  While there are an abundance of online resources, as well as classes on the subject, the most common questions we get relate to which codes to use and how much they will pay.  While we would normally just refer you to the California Department of Industrial Relations website for practitioners (click here), the documents most asked for are the General Information and Instructions on how/what to bill (see here), and the procedural (CPT code) fee schedule for services you have provided.  This fee schedule is updated every so often, and the one we refer to is here.  The fee schedule is listed by section (what type of procedure--surgery, general medicine, anesthesiology, etc.), then CPT code, description, with the maximum payment amount at the end of each line.  Before the maximum payment amount is the reduction percentage, which is taken when a given procedure is used/billed along with others on the same day of service. 

That’s about the most info we can provide on the ‘how tos’ of billiing, especially as it relates to California Worker’s Compensation.  For more information, go to the California Department of Industrial Relations website.  

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