Texas Register

TITLE 28 INSURANCE
PART 2TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
CHAPTER 134BENEFITS--GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
SUBCHAPTER CMEDICAL FEE GUIDELINES
RULE §134.235Return to Work/Evaluation of Medical Care
ISSUE 07/01/2016
ACTION Final/Adopted
Preamble Texas Admin Code Rule

The following shall apply to return to work (RTW)/evaluation of medical care (EMC) examinations. When conducting a division or insurance carrier requested RTW/EMC examination, the examining doctor shall bill and be reimbursed using CPT code 99456 with modifier "RE." In either instance of whether maximum medical improvement/ impairment rating (MMI/IR) is performed or not, the reimbursement shall be $500 in accordance with §134.240 of this title and shall include division-required reports. Testing that is required shall be billed using the appropriate CPT codes and reimbursed in addition to the examination fee.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 17, 2016

TRD-201603100

Nicholas Canaday III

General Counsel

Texas Department of Insurance, Workers' Compensation Division

Effective date: July 7, 2016

Proposal publication date: March 18, 2016

For further information, please call: (512) 804-4703



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