Ohio Admin. Code 4123-6-08 - Bureau fee schedule
(A)
Pursuant to division (A)(1)(h) of section
4121.441 of the Revised Code,
the administrator of workers' compensation, with the advice and consent of the
bureau of workers' compensation board of directors, shall develop, maintain, and publish
develops, maintains, and publishes a provider fee
schedule for the various types of billing codes. The administrator hereby
adopts the professional provider fee schedule
indicated in the appendix to this rule, developed
with provider and employer input, effective January 1, 2022.
(B) Whether the MCO has elected to retain a
provider panel or not, an MCO may contract with providers.
Every provider contract shall describe the method of
payment to the providers. The MCO shall provide an MCO fee schedule to
each provider that contracts with the MCO, describing
the method of payment, and make the MCO fee schedule available to the bureau as
part of its application for certification . The
MCO fee schedule may be at different rates than the bureau fee schedule. The
MCO shall make the MCO fee schedule available to the bureau as part of its
application for certification. The bureau shall
will maintain
the MCO fee schedule as proprietary information.
Notes
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4121.31, 4123.05
Rule Amplifies: 4121.12, 4121.44, 4121.441, 4123.66
Prior Effective Dates: 02/16/1996, 01/01/2001, 02/19/2009, 11/08/2009, 10/25/2010, 12/30/2010 (Emer.), 03/21/2011, 12/30/2011 (Emer.), 03/24/2012, 12/27/2012 (Emer.), 03/24/2013, 12/30/2013 (Emer.), 03/28/2014, 12/30/2014 (Emer.), 01/15/2015 (Emer.), 05/01/2015, 12/31/2015 (Emer.), 05/01/2016, 12/30/2016 (Emer.), 05/01/2017, 12/29/2017 (Emer.), 05/01/2018, 12/31/2018 (Emer.), 05/01/2019, 12/31/2019 (Emer.), 05/16/2020, 12/31/2020 (Emer.), 05/06/2021, 12/30/2021 (Emer.), 05/01/2022, 12/30/2022 (Emer.)
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(A) Pursuant to division (A)(1)(h) of section 4121.441 of the Revised Code, the administrator of workers' compensation, with the advice and consent of the bureau of workers' compensation board of directors, shall develop, maintain, and publish develops, maintains, and publishes a provider fee schedule for the various types of billing codes. The administrator hereby adopts the professional provider fee schedule indicated in the appendix to this rule, developed with provider and employer input, effective January 1, 2022.
(B) Whether the MCO has elected to retain a provider panel or not, an MCO may contract with providers. Every provider contract shall describe the method of payment to the providers. The MCO shall provide an MCO fee schedule to each provider that contracts with the MCO, describing the method of payment, and make the MCO fee schedule available to the bureau as part of its application for certification . The MCO fee schedule may be at different rates than the bureau fee schedule. The MCO shall make the MCO fee schedule available to the bureau as part of its application for certification . The bureau shall will maintain the MCO fee schedule as proprietary information.
Notes
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4121.31, 4123.05
Rule Amplifies: 4121.12, 4121.44, 4121.441, 4123.66
Prior Effective Dates: 02/16/1996, 01/01/2001, 02/19/2009, 11/08/2009, 10/25/2010, 12/30/2010 (Emer.), 03/21/2011, 12/30/2011 (Emer.), 03/24/2012, 12/27/2012 (Emer.), 03/24/2013, 12/30/2013 (Emer.), 03/28/2014, 12/30/2014 (Emer.), 01/15/2015 (Emer.), 05/01/2015, 12/31/2015 (Emer.), 05/01/2016, 12/30/2016 (Emer.), 05/01/2017, 12/29/2017 (Emer.), 05/01/2018, 12/31/2018 (Emer.), 05/01/2019, 12/31/2019 (Emer.), 05/16/2020, 12/31/2020 (Emer.), 05/06/2021, 12/30/2021 (Emer.), 05/01/2022, 12/30/2022 (Emer.)