Currently, the maximum allowable payment for an independent medical examination is $600. This payment represents the maximum amount that a provider can legally be paid for an independent medical exam. In instances where the provider's usual charge is lower than the MAP or where the provider has agreed by contract with an employer or insurance carrier to accept discounts or fees lower than the Commission's MAP, payment is made at the lower amount. The American Medical Association defines an independent medical examination, Physicians Current Procedural Terminology Code 99456, as a work-related or medical disability examination by other than the treating physician that includes completion of a medical history commensurate with the patient's condition; performance of an examination commensurate with the patient's condition; formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; development of future medical treatment plan; and completion of necessary documentation/certificates and report. For more details, visit www.wcc.sc.gov/.
June 1, 2009
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