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
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