Sec. 14.09.08.05. Guidelines for Using Values and Codes

A. The Maryland Workers' Compensation Act, implementing regulations, policies, and guidelines shall take precedence over any conflicting provision adopted or utilized by CMS in administering the CMS program.

B. For coding, billing, reporting, and reimbursement of medical treatment and services, authorized providers shall apply the CPT/HCPCS code and CPT modifier in effect on the date the treatment or service was provided.

C. The Commission shall post instructions for obtaining RVU and GPCI values on its website.

D. RVU and GPCI values shall be obtained utilizing the current year, the locality code for Baltimore and Surrounding Counties (0090101), the applicable CPT/HCPCS code and any CPT modifier.

E. The Commission shall post a link to the Medicare Physician Fee Schedule on its website.

F. The Commission shall post a link to the ASC payment rate instructions on its website.

G. Notwithstanding CMS payment policies, chiropractors may be reimbursed for services provided within the scope of their practice act.

H. For procedures performed or services rendered after September 1, 2004, a multiple procedure discount is not permitted for physical medicine and rehabilitation services (CPT codes 97010-97799).

I. After September 1, 2004, only one code per session will be reimbursed for CPT codes 97012-97039.