RULE NO: RULE TITLE
69L-7.020: Florida Workers' Compensation Health Care Provider Reimbursement Manual
These changes are being made to address concerns expressed by the Joint Administrative Procedures Committee.
The proposed rule has been changed to include the most current editions of reference materials incorporated by reference. The text of the proposed rule is being reprinted to reflect the changes.
69L-7.020 Florida Workers’ Compensation Health Care Provider Reimbursement Manual.
(1) The Florida Workers’ Compensation Health Care Provider Reimbursement Manual, 2008 Edition, is adopted by reference as part of this rule. The manual contains the Maximum Reimbursement Allowances determined by the Three-Member Panel, pursuant to Section 440.13(12), F.S., and establishes reimbursement policies, guidelines, codes and maximum reimbursement allowances for services and supplies provided by health care providers. Also, the manual includes reimbursement policies and payment methodologies for pharmacists and medical suppliers.
(2) The CPT® 20098 Current Procedural Terminology Professional Edition, Copyright 20087, American Medical Association; the Current Dental Terminology, CDT-2009/2010 2007/2008, Copyright 20086, American Dental Association; and in part for D codes and for injectable J codes, and for other medical services and supply codes, the “Healthcare Common Procedure Coding System, Medicare’s National Level II Codes, HCPCS 20098”, American Medical Association, Twenty-first Twentieth Edition, Copyright 20087, Ingenix Publishing Group, are adopted by reference as part of this rule. When a health care provider performs a procedure or service which is not listed in the Florida Workers’ Compensation Health Care Provider Reimbursement Manual, 2008 Edition incorporated above, the provider must use a code contained in the CPT®-20098, CDT-2009/2010 2007/2008 or HCPCS-20098 as specified in this section.
(3) The Florida Workers’ Compensation Health Care Provider Reimbursement Manual, 2008 Edition incorporated above, is available for inspection during normal business hours at the Florida Department of Financial Services, Document Processing Section, 200 East Gaines Street, Tallahassee, Florida 32399-0311, or via the Department’s web site at http://www.fldfs.com/wc.
Specific Authority 440.13(14)(b), 440.591 FS. Law Implemented 440.13(7), (12), (14)(c) FS. History–New 10-1-82, Amended 3-16-83, 11-6-83, 5-21-85, Formerly 38F-7.20, Amended 4-1-88, 7-20-88, 6-1-91, 4-29-92, 2-18-96, 9-1-97, 12-15-97, 9-17-98, 9-30-01, 7-7-02, Formerly 38F-7.020, 4L-7.020, Amended 12-4-03, 1-1-04, 7-4-04, 5-9-05, 9-4-05, 11-16-06, 10-18-07, ________.
The remainder of the rule reads as previously published.