Pennsylvania Code (Last Updated: April 5, 2016) |
Title 34. LABOR AND INDUSTRY |
PART VIII. Bureau of Workers Compensation |
Chapter 127. Workers Compensation Medical Cost Containment |
SubChapter B. MEDICAL FEES AND FEE REVIEW |
Section 127.201. Medical billsstandard forms
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(a) Requests for payment of medical bills shall be made either on the HCFA Form 1500 or the UB92 Form (HCFA Form 1450), or any successor forms, required by HCFA for submission of Medicare claims. If HCFA accepts a form for submission of Medicare claims by a certain provider, that form shall be acceptable for billing under the act.
(b) Cost-based providers shall submit a detailed bill including the service codes consistent with the service codes submitted to the Bureau on the detailed charge master in accordance with § 127.155(b) (relating to medical fee updates on and after January 1, 1995outpatient acute care providers, specialty hospitals and other cost-reimbursed providers), or consistent with new service codes added under § 127.155(d) and (e).
Notation
This section cited in § 127.202 (relating to medical billsuse of alternative forms).