New! Out-of-Country Services Payment Policy - Changes effective July 1
Attention All Firm Managers, please share with your staff.
L&I has adopted a new payment policy for out-of-country services.
Effective July 1, providers located outside the United States will no longer be required to use American CPT® codes for most services. Instead, they will use the appropriate code(s) from the Out of Country Fee Schedule local code.
Additional information about the changes:
- Providers outside the U.S. may use one form for billing and documentation.
- The new Out-of-Country policy, form, and provider guide are available in Spanish.
- Hospitals can bill only for resources and anesthesia during an operation or overnight stay. All other services follow the fee schedule.
- If a service is not listed in the new fee schedule, L&I or the self-insured employer/third-party administrator will determine the most appropriate code from the professional services fee schedule for reimbursement.
Note: Vocational rehabilitation counselor reimbursement remains unchanged.
A frequently asked questions page will be posted in the VRC Resource Library this month. The resource will include links to the new policy, forms, and guides in English and Spanish.
If you have questions about the new payment policy and fee schedule for out-of-country services, email: HPPM@Lni.wa.gov.
For out-of-country provider account & payment questions, email: ForeignProviders@Lni.wa.gov.
This memo will be posted to L&I’s “What’s New for Vocational Counselors” web page.
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