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Chapter 4.5. Division of Workers' Compensation
Subchapter 1. Administrative Director--Administrative Rules
Article 3.6. Independent Medical Review

§9768.15. Charges for Independent Medical Reviewers

(a) Payment for the services of the Independent Medical Reviewers shall be made by the employer or insurer.

(b) The fee shall be based on the Official Medical Fee Schedule using confirmatory consultation codes (99271 through 99275 for in-person examinations or 99271 through 99273 for evaluations not requiring an in-person examination), 99080 for reports, and 99358 for record reviews, and any other appropriate codes or modifiers.

(c) An IMR shall not accept any additional compensation from any source for his or her services as an IMR except for services provided to treat a medical emergency that arose during an in-person examination pursuant to section 9768.11(j).

NOTE

Authority cited: Sections 133 and 4616, Labor Code. Reference: Section 4616.4, Labor Code.

HISTORY

1. New section filed 12-31-2004 as an emergency; operative 1-1-2005 (Register 2004, No. 53). A Certificate of Compliance must be transmitted to OAL by 5-2-2005 or emergency language will be repealed by operation of law on the following day.

2. Certificate of Compliance as to 12-31-2004 order, including amendment of subsections (a) and (b), transmitted to OAL 4-29-2005 and filed 6-10-2005 (Register 2005, No. 23).

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