34 Pa. Code § 127.130 - Special reports

(a) Payments shall be made for special reports (CPT code 99080) only if these reports are specifically requested by the insurer. Office notes and other documentation which are necessary to support provider codes billed may not be considered special reports.
(b) Payments for special reports shall be at 80% of the provider's usual and customary charge.
(c) The Bureau-prescribed report required by § 127.203 (relating to medical bills-submission of medical reports) may not be considered a special report that is chargeable under this section.

Notes

34 Pa. Code § 127.130

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