Florida Regulations 69L-7.020 89

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§ Florida Workers' Compensation Health Care Provider Reimbursement Manual.



(1) The Florida Workers' Compensation Health Care Provider Reimbursement Manual, 2004 Edition, is adopted by reference as part of this rule. The manual contains reimbursement policies, guidelines, codes and maximum reimbursement allowances for medical services and supplies provided by health care providers. The manual provides reimbursement policies and payment

methodologies for pharmacists and medical suppliers. The Florida Workers' Compensation Health Care Provider Reimbursement Manual, 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.

(2) The Physicians' Current Procedural Terminology (CPT), 2003 Professional Edition, Copyright 2002, American Medical Association, the Current Dental Terminology (CDT-4), Fourth Edition, Copyright 2002, American Dental Association and for D codes; injectable J codes, and the other medical services and supply codes, the American Medical Association "Healthcare Common Procedure Coding System, Medicare's National Level II Codes, HCPCS 2003", Fifteenth Edition, Copyright 2002, 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, incorporated in subsection (1) above, the provider must use a code contained in the CPT, CDT-4 or HCPCS section as specified.

Specific Authority 440.13(7), (8), (11)-(14), 440.591 FS. Law Implemented 440.13(6)-(8), (11)-(14) 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.