2020 alabama workers' compensation prevailing …cpt code:12056-2 $760.83 cpt code:12057-2...
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2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $620.270001U-8
CPT CODE: $101.360002U-8
CPT CODE: $110.090003U-8
CPT CODE: $41.480004U-8
CPT CODE: $2,692.770005U-8
CPT CODE: $213.990006U-8
CPT CODE: $99.170007U-8
CPT CODE: $507.540008U-8
CPT CODE: $25.910009U-8
CPT CODE: $88.670010U-8
CPT CODE: $99.170011U-8
CPT CODE: $507.540012U-8
CPT CODE: $507.540013U-8
CPT CODE: $507.540014U-8
CPT CODE: $189.580016U-8
CPT CODE: $105.990017U-8
CPT CODE: $320.3200731-4
CPT CODE: $320.3200732-4
CPT CODE: $20.100080U-8
CPT CODE: $354.0300811-4
CPT CODE: $354.0300812-4
CPT CODE: $354.0300813-4
CPT CODE: $84.100082U-8
CPT CODE: $677.780139U-8
CPT CODE: $23.490140U-8
CPT CODE: $23.490141U-8
CPT CODE: $23.490142U-8
CPT CODE: $90.120143U-8
CPT CODE: $90.120144U-8
CPT CODE: $90.120145U-8
CPT CODE: $90.120146U-8
CPT CODE: $90.120147U-8
CPT CODE: $90.120148U-8
CPT CODE: $90.120149U-8
CPT CODE: $90.120150U-8
CPT CODE: $23.490151U-8
CPT CODE: $23.490152U-8
CPT CODE: $4,553.210153U-8
CPT CODE: $94.200154U-8
CPT CODE: $94.200155U-8
CPT CODE: $2,221.220156U-8
CPT CODE: $545.430157U-8
CPT CODE: $545.430158U-8
CPT CODE: $545.430159U-8
CPT CODE: $545.430160U-8
CPT CODE: $545.430161U-8
CPT CODE: $1,090.860162U-8
CPT CODE: $50.2301953-4
CPT CODE: $570.8101967-4
CPT CODE: $171.2501968-4
CPT CODE: $96.8401996-6
CPT CODE: $219.740437T-2
CPT CODE: $26.070500T-8
CPT CODE: $306.3009220-I
CPT CODE: $45.8510004-2
CPT CODE: $78.0710005-2
CPT CODE: $53.2310006-2
CPT CODE: $100.1310007-2
CPT CODE: $65.3410008-2
CPT CODE: $121.7310009-2
CPT CODE: $88.9710010-2
CPT CODE: $121.7310011-2
CPT CODE: $88.9710012-2
CPT CODE: $75.6010021-2
CPT CODE: $182.0310030-2
CPT CODE: $98.2810035-2
CPT CODE: $49.4510036-2
CPT CODE: $55.3210040-2
CPT CODE: $116.6010060-2
CPT CODE: $189.7310061-2
CPT CODE: $154.1510080-2
CPT CODE: $335.9510081-2
CPT CODE: $110.6710120-2
CPT CODE: $290.4710121-2
CPT CODE: $102.7610140-2
CPT CODE: $94.8610160-2
CPT CODE: $444.6510180-2
CPT CODE: $88.9111000-2
CPT CODE: $61.2611001-2
CPT CODE: $808.0111004-2
CPT CODE: $888.2411005-2
CPT CODE: $1,010.0111006-2
CPT CODE: $535.8111008-2
CPT CODE: $307.2511010-2
CPT CODE: $484.0211011-2
CPT CODE: $669.3911012-2
CPT CODE: $316.2111042-2
CPT CODE: $494.0511043-2
CPT CODE: $691.6911044-2
CPT CODE: $49.7611045-2
CPT CODE: $88.6211046-2
CPT CODE: $145.0311047-2
CPT CODE: $64.1811055-2
CPT CODE: $84.4711056-2
CPT CODE: $106.4311057-2
CPT CODE: $41.6711102-2
CPT CODE: $24.1511103-2
CPT CODE: $52.3311104-2
CPT CODE: $28.5311105-2
CPT CODE: $63.5811106-2
CPT CODE: $34.0611107-2
CPT CODE: $102.7611200-2
CPT CODE: $51.3811201-2
CPT CODE: $82.2811300-2
CPT CODE: $118.6111301-2
CPT CODE: $135.8311302-2
CPT CODE: $185.5911303-2
CPT CODE: $93.7611305-2
CPT CODE: $114.7611306-2
CPT CODE: $181.7711307-2
CPT CODE: $227.6611308-2
CPT CODE: $143.5011310-2
CPT CODE: $214.2811311-2
CPT CODE: $262.1111312-2
CPT CODE: $334.8011313-2
CPT CODE: $105.5611400-2
CPT CODE: $151.8511401-2
CPT CODE: $172.2511402-2
CPT CODE: $235.2111403-2
CPT CODE: $287.0911404-2
CPT CODE: $407.4611406-2
CPT CODE: $120.3811420-2
CPT CODE: $146.3311421-2
CPT CODE: $231.5011422-2
CPT CODE: $287.0911423-2
CPT CODE: $342.6411424-2
CPT CODE: $453.7711426-2
CPT CODE: $144.4611440-2
CPT CODE: $183.3411441-2
CPT CODE: $275.9811442-2
CPT CODE: $333.3911443-2
CPT CODE: $425.9911444-2
CPT CODE: $500.0611446-2
CPT CODE: $929.7511450-2
CPT CODE: $1,215.3811451-2
CPT CODE: $844.5511462-2
CPT CODE: $1,005.6811463-2
CPT CODE: $1,035.3211470-2
CPT CODE: $1,215.3811471-2
CPT CODE: $229.2611600-2
CPT CODE: $272.7411601-2
CPT CODE: $335.9511602-2
CPT CODE: $395.2611603-2
CPT CODE: $484.1711604-2
CPT CODE: $543.4611606-2
CPT CODE: $231.2311620-2
CPT CODE: $292.4911621-2
CPT CODE: $326.0711622-2
CPT CODE: $395.2611623-2
CPT CODE: $503.9511624-2
CPT CODE: $681.8111626-2
CPT CODE: $272.7411640-2
Page 1
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $306.3011641-2
CPT CODE: $375.4611642-2
CPT CODE: $513.8311643-2
CPT CODE: $543.4611644-2
CPT CODE: $671.9211646-2
CPT CODE: $63.5211720-2
CPT CODE: $109.8411721-2
CPT CODE: $130.4211730-2
CPT CODE: $63.2111732-2
CPT CODE: $92.8411740-2
CPT CODE: $533.5911750-2
CPT CODE: $121.3311755-2
CPT CODE: $126.4911760-2
CPT CODE: $563.1911762-2
CPT CODE: $573.0811765-2
CPT CODE: $849.7711770-2
CPT CODE: $1,077.0311771-2
CPT CODE: $1,679.7711772-2
CPT CODE: $55.3211900-2
CPT CODE: $160.0711901-2
CPT CODE: $114.6311920-2
CPT CODE: $173.8911921-2
CPT CODE: $264.7911922-2
CPT CODE: $114.6311950-2
CPT CODE: $173.8911951-2
CPT CODE: $264.7911952-2
CPT CODE: $375.4611954-2
CPT CODE: $3,832.8711960-2
CPT CODE: $4,258.7511970-2
CPT CODE: $4,258.7511971-2
CPT CODE: $215.1311980-2
CPT CODE: $256.1011981-2
CPT CODE: $64.8011982-2
CPT CODE: $320.8911983-2
CPT CODE: $112.6412001-2
CPT CODE: $146.2612002-2
CPT CODE: $193.6612004-2
CPT CODE: $249.0112005-2
CPT CODE: $484.1712006-2
CPT CODE: $523.7012007-2
CPT CODE: $130.4212011-2
CPT CODE: $193.6612013-2
CPT CODE: $247.0212014-2
CPT CODE: $280.6312015-2
CPT CODE: $375.4612016-2
CPT CODE: $503.9512017-2
CPT CODE: $533.5912018-2
CPT CODE: $1,165.9412020-2
CPT CODE: $1,531.5512021-2
CPT CODE: $169.9612031-2
CPT CODE: $235.1512032-2
CPT CODE: $326.0712034-2
CPT CODE: $513.8312035-2
CPT CODE: $622.5012036-2
CPT CODE: $671.9212037-2
CPT CODE: $156.1212041-2
CPT CODE: $231.2312042-2
CPT CODE: $264.7912044-2
CPT CODE: $294.4712045-2
CPT CODE: $444.6512046-2
CPT CODE: $503.9512047-2
CPT CODE: $254.9312051-2
CPT CODE: $326.0712052-2
CPT CODE: $375.4612053-2
CPT CODE: $474.2712054-2
CPT CODE: $523.7012055-2
CPT CODE: $760.8312056-2
CPT CODE: $1,027.6512057-2
CPT CODE: $296.4313100-2
CPT CODE: $345.8413101-2
CPT CODE: $80.8713102-2
CPT CODE: $345.8413120-2
CPT CODE: $533.5913121-2
CPT CODE: $182.7713122-2
CPT CODE: $405.1113131-2
CPT CODE: $830.0213132-2
CPT CODE: $397.8913133-2
CPT CODE: $523.7013151-2
CPT CODE: $889.2813152-2
CPT CODE: $422.1513153-2
CPT CODE: $1,778.6013160-2
CPT CODE: $780.6014000-2
CPT CODE: $1,146.2314001-2
CPT CODE: $770.7314020-2
CPT CODE: $1,403.1414021-2
CPT CODE: $1,086.9414040-2
CPT CODE: $1,462.3814041-2
CPT CODE: $1,324.0714060-2
CPT CODE: $1,926.8014061-2
CPT CODE: $1,871.8014301-2
CPT CODE: $393.6614302-2
CPT CODE: $1,205.4614350-2
CPT CODE: $296.8215002-2
CPT CODE: $149.7715003-2
CPT CODE: $326.5115004-2
CPT CODE: $164.6015005-2
CPT CODE: $254.8515040-2
CPT CODE: $365.5815050-2
CPT CODE: $1,096.7815100-2
CPT CODE: $316.2115101-2
CPT CODE: $811.3715110-2
CPT CODE: $152.9115111-2
CPT CODE: $1,124.0715115-2
CPT CODE: $292.0415116-2
CPT CODE: $1,600.7415120-2
CPT CODE: $622.5015121-2
CPT CODE: $683.2615130-2
CPT CODE: $125.3615131-2
CPT CODE: $1,249.4315135-2
CPT CODE: $170.8115136-2
CPT CODE: $683.2615150-2
CPT CODE: $162.5415151-2
CPT CODE: $199.7515152-2
CPT CODE: $1,000.1015155-2
CPT CODE: $316.8315156-2
CPT CODE: $341.6315157-2
CPT CODE: $830.0215200-2
CPT CODE: $622.5015201-2
CPT CODE: $1,274.6715220-2
CPT CODE: $691.6915221-2
CPT CODE: $1,027.6515240-2
CPT CODE: $938.6815241-2
CPT CODE: $1,788.4515260-2
CPT CODE: $1,077.0315261-2
CPT CODE: $155.1615271-2
CPT CODE: $29.5715272-2
CPT CODE: $318.6415273-2
CPT CODE: $75.6715274-2
CPT CODE: $166.7015275-2
CPT CODE: $36.8015276-2
CPT CODE: $322.9615277-2
CPT CODE: $89.3515278-2
CPT CODE: $2,025.6115570-2
CPT CODE: $2,025.6115572-2
CPT CODE: $2,025.6115574-2
CPT CODE: $2,025.6115576-2
CPT CODE: $879.4115600-2
CPT CODE: $1,126.4615610-2
CPT CODE: $1,877.4015620-2
CPT CODE: $1,877.4015630-2
CPT CODE: $1,887.2915650-2
CPT CODE: $970.6815730-2
CPT CODE: $1,911.8215731-2
CPT CODE: $1,108.4215733-2
CPT CODE: $2,697.5015734-2
CPT CODE: $2,697.5015736-2
CPT CODE: $2,697.5015738-2
CPT CODE: $2,697.5015740-2
CPT CODE: $2,272.6715750-2
CPT CODE: $10,919.5515756-2
CPT CODE: $8,853.0315757-2
CPT CODE: $8,461.7115758-2
Page 2
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $2,272.6715760-2
CPT CODE: $494.8715769-2
CPT CODE: $2,717.3015770-2
CPT CODE: $491.5215771-2
CPT CODE: $146.6515772-2
CPT CODE: $497.0715773-2
CPT CODE: $141.0115774-2
CPT CODE: $63.2115775-2
CPT CODE: $229.2715777-2
CPT CODE: $2,717.3015780-2
CPT CODE: $839.9115781-2
CPT CODE: $582.9815782-2
CPT CODE: $124.5015783-2
CPT CODE: $124.5015786-2
CPT CODE: $110.6715787-2
CPT CODE: $2,715.6615788-2
CPT CODE: $2,715.6615789-2
CPT CODE: $1,073.2015792-2
CPT CODE: $1,073.2015793-2
CPT CODE: $2,272.6715819-2
CPT CODE: $1,610.6015820-2
CPT CODE: $2,312.1715821-2
CPT CODE: $1,827.9815822-2
CPT CODE: $1,827.9815823-2
CPT CODE: $2,272.6715824-2
CPT CODE: $3,399.0915825-2
CPT CODE: $1,827.9815826-2
CPT CODE: $6,610.4415828-2
CPT CODE: $1,827.9815829-2
CPT CODE: $2,558.0915830-2
CPT CODE: $6,610.4415832-2
CPT CODE: $6,610.4415833-2
CPT CODE: $6,610.4415834-2
CPT CODE: $6,610.4415835-2
CPT CODE: $6,610.4415836-2
CPT CODE: $3,142.1915837-2
CPT CODE: $3,142.1915838-2
CPT CODE: $3,142.1915839-2
CPT CODE: $4,406.9415840-2
CPT CODE: $4,406.9415841-2
CPT CODE: $4,406.9415842-2
CPT CODE: $5,355.5715845-2
CPT CODE: $395.3215847-2
CPT CODE: $65.2015850-2
CPT CODE: $65.2015851-2
CPT CODE: $345.8415852-2
CPT CODE: $1,413.0115876-2
CPT CODE: $1,413.0115877-2
CPT CODE: $1,413.0115878-2
CPT CODE: $1,413.0115879-2
CPT CODE: $1,314.1715920-2
CPT CODE: $1,699.5615922-2
CPT CODE: $1,017.7515931-2
CPT CODE: $1,383.3315933-2
CPT CODE: $1,205.4615934-2
CPT CODE: $1,827.9815935-2
CPT CODE: $1,452.5015936-2
CPT CODE: $1,827.9815937-2
CPT CODE: $1,156.0815940-2
CPT CODE: $1,571.0915941-2
CPT CODE: $1,452.5015944-2
CPT CODE: $1,827.9815945-2
CPT CODE: $2,677.7615946-2
CPT CODE: $1,017.7515950-2
CPT CODE: $1,383.3315951-2
CPT CODE: $1,452.5015952-2
CPT CODE: $1,827.9815953-2
CPT CODE: $2,331.9615956-2
CPT CODE: $2,717.3015958-2
CPT CODE: $100.8016000-2
CPT CODE: $96.8416020-2
CPT CODE: $106.7216025-2
CPT CODE: $136.3716030-2
CPT CODE: $316.2116035-2
CPT CODE: $129.4616036-2
CPT CODE: $85.1717000-2
CPT CODE: $37.1717003-3
CPT CODE: $337.8817004-2
CPT CODE: $57.4117110-2
CPT CODE: $77.7117111-2
CPT CODE: $59.2617250-2
CPT CODE: $166.0917260-2
CPT CODE: $201.8717261-2
CPT CODE: $246.3217262-2
CPT CODE: $285.2217263-2
CPT CODE: $351.9017264-2
CPT CODE: $474.1317266-2
CPT CODE: $168.5217270-2
CPT CODE: $214.8217271-2
CPT CODE: $258.8917272-2
CPT CODE: $326.0717273-2
CPT CODE: $395.2617274-2
CPT CODE: $503.9517276-2
CPT CODE: $201.8717280-2
CPT CODE: $205.5217281-2
CPT CODE: $306.3017282-2
CPT CODE: $375.4617283-2
CPT CODE: $474.2717284-2
CPT CODE: $543.4617286-2
CPT CODE: $688.0917311-2
CPT CODE: $315.7217312-2
CPT CODE: $671.9117313-2
CPT CODE: $307.6217314-2
CPT CODE: $70.1617315-2
CPT CODE: $65.2017340-2
CPT CODE: $63.2117360-2
CPT CODE: $118.5917380-2
CPT CODE: $96.8419000-2
CPT CODE: $63.2119001-2
CPT CODE: $523.7019020-2
CPT CODE: $100.8019030-2
CPT CODE: $251.1019081-2
CPT CODE: $121.9819082-2
CPT CODE: $235.8019083-2
CPT CODE: $114.7319084-2
CPT CODE: $275.7519085-2
CPT CODE: $129.0619086-2
CPT CODE: $128.4419100-2
CPT CODE: $681.8119101-2
CPT CODE: $820.1319110-2
CPT CODE: $820.1319112-2
CPT CODE: $780.6019120-2
CPT CODE: $774.5619125-2
CPT CODE: $774.5619126-2
CPT CODE: $252.0319281-2
CPT CODE: $70.9319282-2
CPT CODE: $146.9719283-2
CPT CODE: $71.3819284-2
CPT CODE: $124.6719285-2
CPT CODE: $66.7219286-2
CPT CODE: $196.1319287-2
CPT CODE: $91.5919288-2
CPT CODE: $171.7819294-2
CPT CODE: $984.2319296-2
CPT CODE: $492.8319297-2
CPT CODE: $1,124.6219298-2
CPT CODE: $975.4719300-2
CPT CODE: $871.5919301-2
CPT CODE: $2,427.2219302-2
CPT CODE: $1,261.5019303-2
CPT CODE: $2,440.7119305-2
CPT CODE: $4,356.5819306-2
CPT CODE: $2,433.9619307-2
CPT CODE: $4,673.7619316-2
CPT CODE: $4,673.7619318-2
CPT CODE: $2,588.8719324-2
CPT CODE: $2,588.8719325-2
CPT CODE: $1,363.6019328-2
CPT CODE: $1,086.9419330-2
CPT CODE: $1,215.3819340-2
CPT CODE: $1,798.3319342-2
CPT CODE: $1,995.9919350-2
Page 3
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $1,995.9919355-2
CPT CODE: $3,991.9519357-2
CPT CODE: $2,588.8719361-2
CPT CODE: $14,080.5519364-2
CPT CODE: $2,588.8719366-2
CPT CODE: $10,448.7419367-2
CPT CODE: $10,448.7419368-2
CPT CODE: $10,448.7419369-2
CPT CODE: $938.6819370-2
CPT CODE: $938.6819371-2
CPT CODE: $1,205.4619380-2
CPT CODE: $779.6120100-2
CPT CODE: $1,322.3520101-2
CPT CODE: $1,322.3520102-2
CPT CODE: $525.0520103-2
CPT CODE: $870.2020150-2
CPT CODE: $280.6320200-2
CPT CODE: $444.6520205-2
CPT CODE: $187.7320206-2
CPT CODE: $189.7320220-2
CPT CODE: $879.4120225-2
CPT CODE: $691.6920240-2
CPT CODE: $820.1320245-2
CPT CODE: $2,638.2620250-2
CPT CODE: $2,638.2620251-2
CPT CODE: $124.5020500-2
CPT CODE: $124.5020501-2
CPT CODE: $136.3720520-2
CPT CODE: $1,245.0220525-2
CPT CODE: $58.6320526-2
CPT CODE: $67.7320527-2
CPT CODE: $71.1620550-2
CPT CODE: $58.6320551-2
CPT CODE: $87.9520552-2
CPT CODE: $117.2520553-2
CPT CODE: $557.5420555-2
CPT CODE: $49.4520560-2
CPT CODE: $84.9320561-2
CPT CODE: $83.5620600-2
CPT CODE: $85.6020604-2
CPT CODE: $73.1020605-2
CPT CODE: $94.2820606-2
CPT CODE: $75.1120610-2
CPT CODE: $107.6720611-2
CPT CODE: $57.1320612-2
CPT CODE: $622.5020615-2
CPT CODE: $316.2120650-2
CPT CODE: $1,551.3420660-2
CPT CODE: $2,371.4420661-2
CPT CODE: $691.6920662-2
CPT CODE: $691.6920663-2
CPT CODE: $2,268.7720664-2
CPT CODE: $124.5020665-2
CPT CODE: $800.3820670-2
CPT CODE: $1,165.9420680-2
CPT CODE: $2,075.0220690-2
CPT CODE: $3,942.5420692-2
CPT CODE: $1,966.3120693-2
CPT CODE: $948.6120694-2
CPT CODE: $2,142.5620696-2
CPT CODE: $87.8420700-2
CPT CODE: $65.6420701-2
CPT CODE: $146.0920702-2
CPT CODE: $104.8820703-2
CPT CODE: $152.1920704-2
CPT CODE: $125.3520705-2
CPT CODE: $7,628.2120802-2
CPT CODE: $7,628.2120805-2
CPT CODE: $7,628.2120808-2
CPT CODE: $8,240.8420816-2
CPT CODE: $4,090.7720822-2
CPT CODE: $8,112.3920824-2
CPT CODE: $4,090.7720827-2
CPT CODE: $7,183.5520838-2
CPT CODE: $563.1920900-2
CPT CODE: $3,774.5820902-2
CPT CODE: $1,077.0320910-2
CPT CODE: $1,630.3720912-2
CPT CODE: $444.6520920-2
CPT CODE: $879.4120922-2
CPT CODE: $3,774.5820924-2
CPT CODE: $571.0320930-2
CPT CODE: $571.0320931-2
CPT CODE: $748.9020932-2
CPT CODE: $687.1120933-2
CPT CODE: $748.5120934-2
CPT CODE: $571.0320936-2
CPT CODE: $1,884.5520937-2
CPT CODE: $1,884.5520938-2
CPT CODE: $70.9820939-2
CPT CODE: $294.4720950-2
CPT CODE: $7,114.3620955-2
CPT CODE: $6,117.1420956-2
CPT CODE: $6,117.1420957-2
CPT CODE: $7,114.3620962-2
CPT CODE: $9,683.4920969-2
CPT CODE: $9,683.4920970-2
CPT CODE: $8,053.0920972-2
CPT CODE: $8,053.0920973-2
CPT CODE: $1,916.9420974-2
CPT CODE: $1,905.3120975-2
CPT CODE: $2,826.0221010-2
CPT CODE: $523.5921011-2
CPT CODE: $567.3321012-2
CPT CODE: $816.9121013-2
CPT CODE: $877.3721014-2
CPT CODE: $4,476.1621015-2
CPT CODE: $1,761.1721016-2
CPT CODE: $1,363.6021025-2
CPT CODE: $839.9121026-2
CPT CODE: $1,017.7521029-2
CPT CODE: $839.9121030-2
CPT CODE: $760.8321031-2
CPT CODE: $839.9121032-2
CPT CODE: $2,213.3421034-2
CPT CODE: $760.8321040-2
CPT CODE: $2,331.9621044-2
CPT CODE: $2,331.9621045-2
CPT CODE: $1,987.8321046-2
CPT CODE: $2,983.2421047-2
CPT CODE: $1,987.8321048-2
CPT CODE: $3,195.2721049-2
CPT CODE: $2,826.0221050-2
CPT CODE: $2,826.0221060-2
CPT CODE: $1,363.6021070-2
CPT CODE: $1,887.2921100-2
CPT CODE: $1,225.2421110-2
CPT CODE: $124.5021116-2
CPT CODE: $1,551.3421120-2
CPT CODE: $2,312.1721121-2
CPT CODE: $2,312.1721122-2
CPT CODE: $2,312.1721123-2
CPT CODE: $1,531.5521125-2
CPT CODE: $2,144.2221127-2
CPT CODE: $1,432.7721137-2
CPT CODE: $2,144.2221138-2
CPT CODE: $1,432.7721139-2
CPT CODE: $7,384.3621141-2
CPT CODE: $7,828.0721142-2
CPT CODE: $8,271.8221143-2
CPT CODE: $9,041.2121145-2
CPT CODE: $9,495.7321146-2
CPT CODE: $9,960.1721147-2
CPT CODE: $9,495.7321150-2
CPT CODE: $9,495.7321151-2
CPT CODE: $10,464.0721154-2
CPT CODE: $11,096.4621155-2
CPT CODE: $8,171.6821159-2
CPT CODE: $10,315.8721160-2
CPT CODE: $3,468.2721172-2
CPT CODE: $3,468.2721175-2
CPT CODE: $4,772.5621179-2
Page 4
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $5,385.2221180-2
CPT CODE: $1,017.7521181-2
CPT CODE: $8,813.9621182-2
CPT CODE: $8,813.9621183-2
CPT CODE: $8,813.9621184-2
CPT CODE: $3,063.1621188-2
CPT CODE: $5,918.7721193-2
CPT CODE: $6,531.4021194-2
CPT CODE: $6,472.1321195-2
CPT CODE: $7,282.3721196-2
CPT CODE: $2,242.9921198-2
CPT CODE: $2,038.5621199-2
CPT CODE: $2,826.0221206-2
CPT CODE: $1,620.4921208-2
CPT CODE: $1,511.8121209-2
CPT CODE: $3,073.0221210-2
CPT CODE: $3,073.0221215-2
CPT CODE: $1,630.3721230-2
CPT CODE: $1,620.4921235-2
CPT CODE: $3,893.1821240-2
CPT CODE: $4,140.1721242-2
CPT CODE: $5,829.8721243-2
CPT CODE: $1,818.1521244-2
CPT CODE: $4,970.1921247-2
CPT CODE: $3,073.0221255-2
CPT CODE: $6,985.9221256-2
CPT CODE: $6,985.9221260-2
CPT CODE: $8,744.7921261-2
CPT CODE: $9,308.0021263-2
CPT CODE: $6,985.9221267-2
CPT CODE: $8,744.7921268-2
CPT CODE: $2,045.4021270-2
CPT CODE: $4,663.8721275-2
CPT CODE: $1,254.9121280-2
CPT CODE: $1,254.9121282-2
CPT CODE: $1,630.3721295-2
CPT CODE: $2,075.0221296-2
CPT CODE: $464.3821310-2
CPT CODE: $251.0021315-2
CPT CODE: $711.4421320-2
CPT CODE: $879.4121325-2
CPT CODE: $2,075.0221330-2
CPT CODE: $3,389.2121335-2
CPT CODE: $841.8021336-2
CPT CODE: $249.0121337-2
CPT CODE: $1,254.9121338-2
CPT CODE: $2,075.0221339-2
CPT CODE: $2,756.8221340-2
CPT CODE: $2,519.6921343-2
CPT CODE: $2,888.7821344-2
CPT CODE: $2,885.2721345-2
CPT CODE: $2,756.8221346-2
CPT CODE: $3,962.2921347-2
CPT CODE: $3,242.7021348-2
CPT CODE: $691.6921355-2
CPT CODE: $1,511.3521356-2
CPT CODE: $1,432.7721360-2
CPT CODE: $3,814.1021365-2
CPT CODE: $4,151.4221366-2
CPT CODE: $2,559.2121385-2
CPT CODE: $2,519.6921386-2
CPT CODE: $3,468.2721387-2
CPT CODE: $3,013.7421390-2
CPT CODE: $3,962.2921395-2
CPT CODE: $938.6821400-2
CPT CODE: $1,887.2921401-2
CPT CODE: $2,519.6921406-2
CPT CODE: $3,043.3721407-2
CPT CODE: $2,946.1621408-2
CPT CODE: $1,699.5621421-2
CPT CODE: $2,569.1021422-2
CPT CODE: $3,185.3221423-2
CPT CODE: $2,075.0221431-2
CPT CODE: $4,159.9521432-2
CPT CODE: $5,721.1521433-2
CPT CODE: $9,436.4421435-2
CPT CODE: $10,273.2921436-2
CPT CODE: $938.6821440-2
CPT CODE: $1,808.2421445-2
CPT CODE: $928.8221450-2
CPT CODE: $987.1621451-2
CPT CODE: $1,870.6221452-2
CPT CODE: $1,887.2921453-2
CPT CODE: $3,596.7121454-2
CPT CODE: $2,450.5121461-2
CPT CODE: $2,687.6521462-2
CPT CODE: $1,887.2921465-2
CPT CODE: $4,515.6521470-2
CPT CODE: $292.4921480-2
CPT CODE: $474.2721485-2
CPT CODE: $1,887.2921490-2
CPT CODE: $1,383.3321497-2
CPT CODE: $513.8321501-2
CPT CODE: $1,324.0721502-2
CPT CODE: $938.6821510-2
CPT CODE: $249.0121550-2
CPT CODE: $756.4421552-2
CPT CODE: $1,246.5821554-2
CPT CODE: $124.5021555-2
CPT CODE: $251.0021556-2
CPT CODE: $4,742.9321557-2
CPT CODE: $2,342.6521558-2
CPT CODE: $1,324.0721600-2
CPT CODE: $2,595.0521601-2
CPT CODE: $3,571.1521602-2
CPT CODE: $2,473.5821603-2
CPT CODE: $1,324.0721610-2
CPT CODE: $3,201.4621615-2
CPT CODE: $4,772.5621616-2
CPT CODE: $3,201.4621620-2
CPT CODE: $2,826.0221627-2
CPT CODE: $4,772.5621630-2
CPT CODE: $6,047.2421632-2
CPT CODE: $1,928.6321685-2
CPT CODE: $1,699.5621700-2
CPT CODE: $2,826.0221705-2
CPT CODE: $1,689.6421720-2
CPT CODE: $1,936.7021725-2
CPT CODE: $5,661.8821740-2
CPT CODE: $1,819.4321742-2
CPT CODE: $1,819.4321743-2
CPT CODE: $3,201.4621750-2
CPT CODE: $666.3421811-2
CPT CODE: $799.4221812-2
CPT CODE: $1,094.5321813-2
CPT CODE: $513.8321820-2
CPT CODE: $1,887.2921825-2
CPT CODE: $249.0121920-2
CPT CODE: $513.8321925-2
CPT CODE: $249.0121930-2
CPT CODE: $791.1821931-2
CPT CODE: $1,135.9521932-2
CPT CODE: $1,253.0121933-2
CPT CODE: $4,742.9321935-2
CPT CODE: $2,435.2721936-2
CPT CODE: $1,288.0122010-2
CPT CODE: $1,288.0122015-2
CPT CODE: $1,758.8422100-2
CPT CODE: $1,758.8422101-2
CPT CODE: $1,758.8422102-2
CPT CODE: $1,014.7522103-2
CPT CODE: $3,912.9022110-2
CPT CODE: $3,912.9022112-2
CPT CODE: $3,912.9022114-2
CPT CODE: $1,014.7522116-2
CPT CODE: $4,176.9722206-2
CPT CODE: $4,122.6422207-2
CPT CODE: $1,023.2322208-2
CPT CODE: $4,772.5622210-2
CPT CODE: $4,772.5622212-2
CPT CODE: $4,772.5622214-2
CPT CODE: $1,196.8322216-2
Page 5
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $5,533.4122220-2
CPT CODE: $5,533.4122222-2
CPT CODE: $5,533.4122224-2
CPT CODE: $1,196.8322226-2
CPT CODE: $592.8722310-2
CPT CODE: $1,887.2922315-2
CPT CODE: $1,724.1722318-2
CPT CODE: $2,154.4222319-2
CPT CODE: $4,406.9422325-2
CPT CODE: $4,406.9422326-2
CPT CODE: $4,406.9422327-2
CPT CODE: $1,322.3522328-2
CPT CODE: $513.8322505-2
CPT CODE: $2,018.6622510-2
CPT CODE: $1,997.5322511-2
CPT CODE: $1,115.6822512-2
CPT CODE: $626.3922513-2
CPT CODE: $584.8222514-2
CPT CODE: $262.2322515-2
CPT CODE: $4,378.1622532-2
CPT CODE: $4,178.9422533-2
CPT CODE: $1,007.8522534-2
CPT CODE: $6,047.2422548-2
CPT CODE: $4,654.2822551-2
CPT CODE: $1,536.8922552-2
CPT CODE: $5,742.6522554-2
CPT CODE: $6,847.5922556-2
CPT CODE: $5,464.2222558-2
CPT CODE: $1,324.0722585-2
CPT CODE: $2,939.8522586-2
CPT CODE: $6,047.2422590-2
CPT CODE: $6,047.2422595-2
CPT CODE: $5,357.7922600-2
CPT CODE: $5,227.0822610-2
CPT CODE: $6,518.5822612-2
CPT CODE: $1,322.3522614-2
CPT CODE: $6,847.5922630-2
CPT CODE: $1,322.3522632-2
CPT CODE: $3,741.2622633-2
CPT CODE: $1,164.6422634-2
CPT CODE: $6,412.8322800-2
CPT CODE: $6,798.2022802-2
CPT CODE: $7,389.6522804-2
CPT CODE: $3,371.3222808-2
CPT CODE: $6,412.8322810-2
CPT CODE: $6,798.2022812-2
CPT CODE: $5,689.7022818-2
CPT CODE: $6,833.3722819-2
CPT CODE: $3,260.7822830-2
CPT CODE: $5,355.5622840-2
CPT CODE: $3,424.3522841-2
CPT CODE: $5,371.3622842-2
CPT CODE: $5,337.1822843-2
CPT CODE: $5,798.5922844-2
CPT CODE: $2,125.4422845-2
CPT CODE: $3,053.1222846-2
CPT CODE: $3,487.9922847-2
CPT CODE: $1,322.3522848-2
CPT CODE: $4,723.1722849-2
CPT CODE: $3,428.7522850-2
CPT CODE: $4,873.3722852-2
CPT CODE: $280.4622853-2
CPT CODE: $363.0522854-2
CPT CODE: $2,015.7422855-2
CPT CODE: $672.0022858-2
CPT CODE: $363.0522859-2
CPT CODE: $4,100.6522900-2
CPT CODE: $1,120.5122901-2
CPT CODE: $699.8322902-2
CPT CODE: $742.2922903-2
CPT CODE: $1,757.3122904-2
CPT CODE: $2,278.3222905-2
CPT CODE: $928.8223000-2
CPT CODE: $2,401.0923020-2
CPT CODE: $185.7723030-2
CPT CODE: $247.0223031-2
CPT CODE: $938.6823035-2
CPT CODE: $2,203.4823040-2
CPT CODE: $1,077.0323044-2
CPT CODE: $249.0123065-2
CPT CODE: $513.8323066-2
CPT CODE: $702.4123071-2
CPT CODE: $1,233.7223073-2
CPT CODE: $543.4623075-2
CPT CODE: $1,086.9423076-2
CPT CODE: $4,742.9323077-2
CPT CODE: $2,372.2323078-2
CPT CODE: $2,401.0923100-2
CPT CODE: $1,077.0323101-2
CPT CODE: $3,270.6623105-2
CPT CODE: $1,452.5023106-2
CPT CODE: $2,203.4823107-2
CPT CODE: $1,571.0923120-2
CPT CODE: $1,571.0923125-2
CPT CODE: $1,580.9623130-2
CPT CODE: $1,324.0723140-2
CPT CODE: $1,936.7023145-2
CPT CODE: $1,571.0923146-2
CPT CODE: $3,468.2723150-2
CPT CODE: $5,227.0823155-2
CPT CODE: $4,100.6523156-2
CPT CODE: $1,383.3323170-2
CPT CODE: $1,077.0323172-2
CPT CODE: $2,826.0223174-2
CPT CODE: $1,077.0323180-2
CPT CODE: $1,077.0323182-2
CPT CODE: $2,826.0223184-2
CPT CODE: $1,571.0923190-2
CPT CODE: $1,571.0923195-2
CPT CODE: $3,774.5823200-2
CPT CODE: $5,978.0623210-2
CPT CODE: $2,885.2723220-2
CPT CODE: $126.4923330-2
CPT CODE: $678.3023333-2
CPT CODE: $1,206.1523334-2
CPT CODE: $1,478.5123335-2
CPT CODE: $126.4923350-2
CPT CODE: $4,406.9423395-2
CPT CODE: $4,406.9423397-2
CPT CODE: $2,519.6923400-2
CPT CODE: $1,758.8423405-2
CPT CODE: $2,638.2623406-2
CPT CODE: $2,134.3223410-2
CPT CODE: $3,171.8323412-2
CPT CODE: $859.6423415-2
CPT CODE: $3,592.7623420-2
CPT CODE: $2,638.2623430-2
CPT CODE: $2,638.2623440-2
CPT CODE: $3,616.4623450-2
CPT CODE: $4,100.6523455-2
CPT CODE: $4,406.9423460-2
CPT CODE: $3,962.2923462-2
CPT CODE: $3,774.5823465-2
CPT CODE: $3,774.5823466-2
CPT CODE: $4,268.6623470-2
CPT CODE: $5,345.7023472-2
CPT CODE: $2,850.9923473-2
CPT CODE: $3,579.6823474-2
CPT CODE: $2,203.4823480-2
CPT CODE: $2,638.2623485-2
CPT CODE: $1,887.2923490-2
CPT CODE: $2,776.6023491-2
CPT CODE: $375.4623500-2
CPT CODE: $543.4623505-2
CPT CODE: $1,660.0423515-2
CPT CODE: $251.0023520-2
CPT CODE: $622.5023525-2
CPT CODE: $1,571.0923530-2
CPT CODE: $1,758.8423532-2
CPT CODE: $622.5023540-2
CPT CODE: $760.8323545-2
CPT CODE: $1,788.4523550-2
Page 6
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $1,926.8023552-2
CPT CODE: $345.8423570-2
CPT CODE: $760.8323575-2
CPT CODE: $1,887.2923585-2
CPT CODE: $1,007.8623600-2
CPT CODE: $1,561.2323605-2
CPT CODE: $2,776.6023615-2
CPT CODE: $2,888.7823616-2
CPT CODE: $345.8423620-2
CPT CODE: $760.8323625-2
CPT CODE: $1,936.7023630-2
CPT CODE: $711.4423650-2
CPT CODE: $889.2823655-2
CPT CODE: $2,826.0223660-2
CPT CODE: $582.9823665-2
CPT CODE: $2,638.2623670-2
CPT CODE: $879.4123675-2
CPT CODE: $3,705.4223680-2
CPT CODE: $830.0223700-2
CPT CODE: $3,903.0223800-2
CPT CODE: $4,406.9423802-2
CPT CODE: $5,039.3323900-2
CPT CODE: $3,774.5823920-2
CPT CODE: $691.6923921-2
CPT CODE: $185.7723930-2
CPT CODE: $124.5023931-2
CPT CODE: $938.6823935-2
CPT CODE: $2,025.6124000-2
CPT CODE: $2,343.5224006-2
CPT CODE: $251.0024065-2
CPT CODE: $513.8324066-2
CPT CODE: $681.8324071-2
CPT CODE: $1,171.9724073-2
CPT CODE: $642.2724075-2
CPT CODE: $1,175.8624076-2
CPT CODE: $4,742.9324077-2
CPT CODE: $2,185.7024079-2
CPT CODE: $1,195.5924100-2
CPT CODE: $1,768.7224101-2
CPT CODE: $2,193.6224102-2
CPT CODE: $889.2824105-2
CPT CODE: $2,193.6224110-2
CPT CODE: $2,717.3024115-2
CPT CODE: $2,331.9624116-2
CPT CODE: $1,758.8424120-2
CPT CODE: $2,203.4824125-2
CPT CODE: $1,936.7024126-2
CPT CODE: $2,025.6124130-2
CPT CODE: $2,638.2624134-2
CPT CODE: $1,758.8424136-2
CPT CODE: $1,324.0724138-2
CPT CODE: $2,638.2624140-2
CPT CODE: $1,758.8424145-2
CPT CODE: $1,324.0724147-2
CPT CODE: $1,714.6624149-2
CPT CODE: $5,978.0624150-2
CPT CODE: $3,962.2924152-2
CPT CODE: $3,270.6624155-2
CPT CODE: $1,324.0724160-2
CPT CODE: $879.4124164-2
CPT CODE: $116.6024200-2
CPT CODE: $642.2724201-2
CPT CODE: $124.5024220-2
CPT CODE: $546.1324300-2
CPT CODE: $2,588.8724301-2
CPT CODE: $1,324.0724305-2
CPT CODE: $1,077.0324310-2
CPT CODE: $2,717.3024320-2
CPT CODE: $2,638.2624330-2
CPT CODE: $3,468.2724331-2
CPT CODE: $1,201.8224332-2
CPT CODE: $2,203.4824340-2
CPT CODE: $2,490.4624341-2
CPT CODE: $3,082.8924342-2
CPT CODE: $2,238.5524343-2
CPT CODE: $4,415.3524344-2
CPT CODE: $2,238.5524345-2
CPT CODE: $4,415.3524346-2
CPT CODE: $672.6624357-2
CPT CODE: $967.5924358-2
CPT CODE: $1,067.2024359-2
CPT CODE: $4,525.5524360-2
CPT CODE: $3,774.5824361-2
CPT CODE: $3,774.5824362-2
CPT CODE: $5,592.6924363-2
CPT CODE: $1,383.3324365-2
CPT CODE: $2,203.4824366-2
CPT CODE: $3,146.5324370-2
CPT CODE: $3,625.7424371-2
CPT CODE: $2,203.4824400-2
CPT CODE: $2,519.6924410-2
CPT CODE: $3,468.2724420-2
CPT CODE: $3,774.5824430-2
CPT CODE: $4,406.9424435-2
CPT CODE: $2,203.4824470-2
CPT CODE: $1,936.7024495-2
CPT CODE: $2,776.6024498-2
CPT CODE: $770.7324500-2
CPT CODE: $1,126.4624505-2
CPT CODE: $2,776.6024515-2
CPT CODE: $2,659.2224516-2
CPT CODE: $780.6024530-2
CPT CODE: $1,126.4624535-2
CPT CODE: $2,193.6224538-2
CPT CODE: $3,082.8924545-2
CPT CODE: $2,946.1624546-2
CPT CODE: $444.6524560-2
CPT CODE: $879.4124565-2
CPT CODE: $1,511.8124566-2
CPT CODE: $1,936.7024575-2
CPT CODE: $563.1924576-2
CPT CODE: $1,037.5024577-2
CPT CODE: $2,826.0224579-2
CPT CODE: $1,511.8124582-2
CPT CODE: $4,476.1624586-2
CPT CODE: $4,476.1624587-2
CPT CODE: $365.5824600-2
CPT CODE: $760.8324605-2
CPT CODE: $2,203.4824615-2
CPT CODE: $879.4124620-2
CPT CODE: $2,322.0524635-2
CPT CODE: $177.8424640-2
CPT CODE: $760.8324650-2
CPT CODE: $928.8224655-2
CPT CODE: $1,995.9924665-2
CPT CODE: $2,638.2624666-2
CPT CODE: $316.2124670-2
CPT CODE: $691.6924675-2
CPT CODE: $1,610.6024685-2
CPT CODE: $3,527.5324800-2
CPT CODE: $3,962.2924802-2
CPT CODE: $2,203.4824900-2
CPT CODE: $1,936.7024920-2
CPT CODE: $691.6924925-2
CPT CODE: $2,203.4824930-2
CPT CODE: $2,638.2624931-2
CPT CODE: $1,818.1524935-2
CPT CODE: $3,774.5824940-2
CPT CODE: $1,037.5025000-2
CPT CODE: $900.9625001-2
CPT CODE: $928.8225020-2
CPT CODE: $1,936.7025023-2
CPT CODE: $433.5225024-2
CPT CODE: $1,851.2925025-2
CPT CODE: $185.7725028-2
CPT CODE: $124.5025031-2
CPT CODE: $928.8225035-2
CPT CODE: $2,025.6125040-2
CPT CODE: $249.0125065-2
CPT CODE: $513.8325066-2
CPT CODE: $713.9825071-2
CPT CODE: $888.9525073-2
Page 7
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $830.0225075-2
CPT CODE: $1,175.8625076-2
CPT CODE: $4,742.9325077-2
CPT CODE: $1,906.5325078-2
CPT CODE: $1,571.0925085-2
CPT CODE: $1,195.5925100-2
CPT CODE: $1,195.5925101-2
CPT CODE: $1,887.2925105-2
CPT CODE: $1,511.8125107-2
CPT CODE: $588.2625109-2
CPT CODE: $760.8325110-2
CPT CODE: $978.2325111-2
CPT CODE: $1,195.5925112-2
CPT CODE: $2,282.5025115-2
CPT CODE: $2,272.6725116-2
CPT CODE: $1,086.9425118-2
CPT CODE: $1,887.2925119-2
CPT CODE: $1,729.1825120-2
CPT CODE: $2,163.9525125-2
CPT CODE: $1,887.2925126-2
CPT CODE: $1,195.5925130-2
CPT CODE: $1,630.3725135-2
CPT CODE: $1,630.3725136-2
CPT CODE: $1,758.8425145-2
CPT CODE: $1,758.8425150-2
CPT CODE: $1,758.8425151-2
CPT CODE: $3,774.5825170-2
CPT CODE: $1,274.6725210-2
CPT CODE: $2,203.4825215-2
CPT CODE: $1,383.3325230-2
CPT CODE: $1,383.3325240-2
CPT CODE: $124.5025246-2
CPT CODE: $820.1325248-2
CPT CODE: $820.1325250-2
CPT CODE: $1,254.9125251-2
CPT CODE: $379.5225259-2
CPT CODE: $1,286.2525260-2
CPT CODE: $1,802.8025263-2
CPT CODE: $2,704.1925265-2
CPT CODE: $1,043.1725270-2
CPT CODE: $1,286.2525272-2
CPT CODE: $1,802.8025274-2
CPT CODE: $1,073.7525275-2
CPT CODE: $1,511.8125280-2
CPT CODE: $1,077.0325290-2
CPT CODE: $1,383.3325295-2
CPT CODE: $2,401.0925300-2
CPT CODE: $2,075.0225301-2
CPT CODE: $2,075.0225310-2
CPT CODE: $2,401.0925312-2
CPT CODE: $2,401.0925315-2
CPT CODE: $3,270.6625316-2
CPT CODE: $3,596.7125320-2
CPT CODE: $3,065.2025332-2
CPT CODE: $3,596.7125335-2
CPT CODE: $2,405.6825337-2
CPT CODE: $1,887.2925350-2
CPT CODE: $2,638.2625355-2
CPT CODE: $2,203.4825360-2
CPT CODE: $3,082.8925365-2
CPT CODE: $3,082.8925370-2
CPT CODE: $3,903.0225375-2
CPT CODE: $2,203.4825390-2
CPT CODE: $2,717.3025391-2
CPT CODE: $3,082.8925392-2
CPT CODE: $3,468.2725393-2
CPT CODE: $1,152.4425394-2
CPT CODE: $2,450.5125400-2
CPT CODE: $2,885.2725405-2
CPT CODE: $3,270.6625415-2
CPT CODE: $3,774.5825420-2
CPT CODE: $2,717.3025425-2
CPT CODE: $3,468.2725426-2
CPT CODE: $809.9525430-2
CPT CODE: $1,780.3325431-2
CPT CODE: $2,717.3025440-2
CPT CODE: $1,630.3725441-2
CPT CODE: $1,620.4925442-2
CPT CODE: $1,887.2925443-2
CPT CODE: $1,887.2925444-2
CPT CODE: $1,887.2925445-2
CPT CODE: $3,962.2925446-2
CPT CODE: $2,806.2225447-2
CPT CODE: $1,887.2925449-2
CPT CODE: $1,324.0725450-2
CPT CODE: $1,887.2925455-2
CPT CODE: $2,203.4825490-2
CPT CODE: $1,936.7025491-2
CPT CODE: $2,964.3625492-2
CPT CODE: $573.0825500-2
CPT CODE: $760.8325505-2
CPT CODE: $2,203.4825515-2
CPT CODE: $1,740.9325520-2
CPT CODE: $2,525.3225525-2
CPT CODE: $2,525.3225526-2
CPT CODE: $484.1725530-2
CPT CODE: $968.3425535-2
CPT CODE: $1,936.7025545-2
CPT CODE: $642.2725560-2
CPT CODE: $1,225.2425565-2
CPT CODE: $2,831.3625574-2
CPT CODE: $3,250.8725575-2
CPT CODE: $711.4425600-2
CPT CODE: $899.1625605-2
CPT CODE: $1,086.1125606-2
CPT CODE: $1,051.0325607-2
CPT CODE: $1,107.6925608-2
CPT CODE: $1,230.4725609-2
CPT CODE: $513.8325622-2
CPT CODE: $978.2325624-2
CPT CODE: $2,005.8825628-2
CPT CODE: $474.2725630-2
CPT CODE: $741.0825635-2
CPT CODE: $1,887.2925645-2
CPT CODE: $444.6525650-2
CPT CODE: $475.1625651-2
CPT CODE: $592.4225652-2
CPT CODE: $760.8325660-2
CPT CODE: $1,936.7025670-2
CPT CODE: $900.9625671-2
CPT CODE: $691.6925675-2
CPT CODE: $1,383.3325676-2
CPT CODE: $1,324.0725680-2
CPT CODE: $1,887.2925685-2
CPT CODE: $1,077.0325690-2
CPT CODE: $1,630.3725695-2
CPT CODE: $2,450.5125800-2
CPT CODE: $3,013.7425805-2
CPT CODE: $3,013.7425810-2
CPT CODE: $2,450.5125820-2
CPT CODE: $2,964.3625825-2
CPT CODE: $2,886.7925830-2
CPT CODE: $1,887.2925900-2
CPT CODE: $1,758.8425905-2
CPT CODE: $691.6925907-2
CPT CODE: $1,936.7025909-2
CPT CODE: $1,887.2925915-2
CPT CODE: $1,887.2925920-2
CPT CODE: $691.6925922-2
CPT CODE: $1,887.2925924-2
CPT CODE: $1,571.0925927-2
CPT CODE: $563.1925929-2
CPT CODE: $1,571.0925931-2
CPT CODE: $126.4926010-2
CPT CODE: $278.6126011-2
CPT CODE: $928.8226020-2
CPT CODE: $800.3826025-2
CPT CODE: $1,571.0926030-2
CPT CODE: $928.8226034-2
CPT CODE: $938.6826035-2
CPT CODE: $1,383.3326037-2
CPT CODE: $563.1926040-2
Page 8
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $1,383.3326045-2
CPT CODE: $839.9126055-2
CPT CODE: $563.1926060-2
CPT CODE: $978.2326070-2
CPT CODE: $820.1326075-2
CPT CODE: $780.6026080-2
CPT CODE: $978.2326100-2
CPT CODE: $820.1326105-2
CPT CODE: $691.6926110-2
CPT CODE: $692.1226111-2
CPT CODE: $910.8226113-2
CPT CODE: $622.5026115-2
CPT CODE: $1,086.9426116-2
CPT CODE: $1,324.0726117-2
CPT CODE: $1,786.8926118-2
CPT CODE: $1,709.4326121-2
CPT CODE: $1,709.4326123-2
CPT CODE: $691.6926125-2
CPT CODE: $1,383.3326130-2
CPT CODE: $1,551.3426135-2
CPT CODE: $1,383.3326140-2
CPT CODE: $1,551.3426145-2
CPT CODE: $859.6426160-2
CPT CODE: $820.1326170-2
CPT CODE: $820.1326180-2
CPT CODE: $851.3326185-2
CPT CODE: $1,383.3326200-2
CPT CODE: $1,758.8426205-2
CPT CODE: $1,254.9126210-2
CPT CODE: $1,620.4926215-2
CPT CODE: $1,077.0326230-2
CPT CODE: $820.1326235-2
CPT CODE: $691.6926236-2
CPT CODE: $1,630.3726250-2
CPT CODE: $1,630.3726260-2
CPT CODE: $1,630.3726262-2
CPT CODE: $1,086.9426320-2
CPT CODE: $217.5426340-2
CPT CODE: $79.7426341-2
CPT CODE: $1,590.0926350-2
CPT CODE: $2,785.2426352-2
CPT CODE: $1,802.8026356-2
CPT CODE: $1,802.8026357-2
CPT CODE: $2,785.2426358-2
CPT CODE: $1,661.0226370-2
CPT CODE: $2,126.8926372-2
CPT CODE: $1,671.1626373-2
CPT CODE: $1,671.1626390-2
CPT CODE: $2,258.5526392-2
CPT CODE: $648.2126410-2
CPT CODE: $1,417.9526412-2
CPT CODE: $891.2826415-2
CPT CODE: $1,144.4726416-2
CPT CODE: $708.9526418-2
CPT CODE: $1,417.9526420-2
CPT CODE: $1,661.0226426-2
CPT CODE: $2,258.5526428-2
CPT CODE: $577.3126432-2
CPT CODE: $708.9526433-2
CPT CODE: $840.6226434-2
CPT CODE: $638.0526437-2
CPT CODE: $1,103.9726440-2
CPT CODE: $1,103.9726442-2
CPT CODE: $840.6226445-2
CPT CODE: $1,043.1726449-2
CPT CODE: $840.6226450-2
CPT CODE: $577.3126455-2
CPT CODE: $577.3126460-2
CPT CODE: $1,417.9526471-2
CPT CODE: $1,103.9726474-2
CPT CODE: $1,154.6026476-2
CPT CODE: $1,154.6026477-2
CPT CODE: $1,671.1626478-2
CPT CODE: $1,671.1626479-2
CPT CODE: $1,802.8026480-2
CPT CODE: $2,390.2526483-2
CPT CODE: $2,258.5526485-2
CPT CODE: $2,785.2426489-2
CPT CODE: $2,126.8926490-2
CPT CODE: $2,785.2426492-2
CPT CODE: $2,511.7826494-2
CPT CODE: $2,126.8926496-2
CPT CODE: $2,126.8926497-2
CPT CODE: $2,785.2426498-2
CPT CODE: $2,126.8926499-2
CPT CODE: $1,417.9526500-2
CPT CODE: $1,671.1626502-2
CPT CODE: $1,671.1626508-2
CPT CODE: $2,501.6326510-2
CPT CODE: $1,383.3326516-2
CPT CODE: $2,075.0226517-2
CPT CODE: $2,450.5126518-2
CPT CODE: $1,383.3326520-2
CPT CODE: $1,294.4126525-2
CPT CODE: $1,630.3726530-2
CPT CODE: $1,887.2926531-2
CPT CODE: $1,245.0226535-2
CPT CODE: $1,887.2926536-2
CPT CODE: $1,887.2926540-2
CPT CODE: $2,331.9626541-2
CPT CODE: $1,847.7826542-2
CPT CODE: $1,630.3726545-2
CPT CODE: $1,678.6126546-2
CPT CODE: $1,383.3326548-2
CPT CODE: $5,523.5026550-2
CPT CODE: $6,505.0426551-2
CPT CODE: $6,693.8226553-2
CPT CODE: $6,505.0426554-2
CPT CODE: $5,978.0626555-2
CPT CODE: $4,587.8726556-2
CPT CODE: $1,571.0926560-2
CPT CODE: $2,203.4826561-2
CPT CODE: $2,964.3626562-2
CPT CODE: $1,630.3726565-2
CPT CODE: $1,630.3726567-2
CPT CODE: $2,163.9526568-2
CPT CODE: $2,697.5026580-2
CPT CODE: $1,630.3726587-2
CPT CODE: $1,324.0726590-2
CPT CODE: $2,450.5126591-2
CPT CODE: $1,630.3726593-2
CPT CODE: $2,025.6126596-2
CPT CODE: $262.8026600-2
CPT CODE: $602.7526605-2
CPT CODE: $938.6826607-2
CPT CODE: $908.7526608-2
CPT CODE: $948.6126615-2
CPT CODE: $543.4626641-2
CPT CODE: $543.4626645-2
CPT CODE: $978.2326650-2
CPT CODE: $2,005.8826665-2
CPT CODE: $513.8326670-2
CPT CODE: $563.1926675-2
CPT CODE: $869.5326676-2
CPT CODE: $1,254.9126685-2
CPT CODE: $1,254.9126686-2
CPT CODE: $249.0126700-2
CPT CODE: $513.8326705-2
CPT CODE: $839.9126706-2
CPT CODE: $1,225.2426715-2
CPT CODE: $195.6526720-2
CPT CODE: $464.3826725-2
CPT CODE: $839.9126727-2
CPT CODE: $1,126.4626735-2
CPT CODE: $335.9526740-2
CPT CODE: $484.1726742-2
CPT CODE: $1,393.2126746-2
CPT CODE: $130.4226750-2
CPT CODE: $249.0126755-2
CPT CODE: $355.7526756-2
CPT CODE: $553.3326765-2
CPT CODE: $156.1226770-2
Page 9
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $187.7326775-2
CPT CODE: $355.7526776-2
CPT CODE: $652.1926785-2
CPT CODE: $2,203.4826820-2
CPT CODE: $1,758.8426841-2
CPT CODE: $2,203.4826842-2
CPT CODE: $1,758.8426843-2
CPT CODE: $2,203.4826844-2
CPT CODE: $1,630.3726850-2
CPT CODE: $2,075.0226852-2
CPT CODE: $1,254.9126860-2
CPT CODE: $622.5026861-2
CPT CODE: $1,630.3726862-2
CPT CODE: $820.1326863-2
CPT CODE: $1,096.7826910-2
CPT CODE: $642.2726951-2
CPT CODE: $830.0226952-2
CPT CODE: $185.7726990-2
CPT CODE: $96.8426991-2
CPT CODE: $938.6826992-2
CPT CODE: $563.1927000-2
CPT CODE: $691.6927001-2
CPT CODE: $691.6927003-2
CPT CODE: $1,324.0727005-2
CPT CODE: $1,324.0727006-2
CPT CODE: $1,887.2927025-2
CPT CODE: $1,702.4827027-2
CPT CODE: $3,082.8927030-2
CPT CODE: $2,964.3627033-2
CPT CODE: $3,774.5827035-2
CPT CODE: $3,686.7527036-2
CPT CODE: $249.0127040-2
CPT CODE: $513.8327041-2
CPT CODE: $789.8927043-2
CPT CODE: $1,256.8727045-2
CPT CODE: $810.2627047-2
CPT CODE: $1,165.9427048-2
CPT CODE: $4,742.9327049-2
CPT CODE: $1,324.0727050-2
CPT CODE: $3,073.0227052-2
CPT CODE: $4,406.9427054-2
CPT CODE: $1,873.7927057-2
CPT CODE: $3,406.5527059-2
CPT CODE: $1,077.0327060-2
CPT CODE: $820.1327062-2
CPT CODE: $1,077.0327065-2
CPT CODE: $1,699.5627066-2
CPT CODE: $1,699.5627067-2
CPT CODE: $1,077.0327070-2
CPT CODE: $2,826.0227071-2
CPT CODE: $5,978.0627075-2
CPT CODE: $5,978.0627076-2
CPT CODE: $5,978.0627077-2
CPT CODE: $5,978.0627078-2
CPT CODE: $1,482.1527080-2
CPT CODE: $124.5027086-2
CPT CODE: $760.8327087-2
CPT CODE: $3,082.8927090-2
CPT CODE: $3,073.0227091-2
CPT CODE: $154.1527093-2
CPT CODE: $154.1527095-2
CPT CODE: $88.9727096-2
CPT CODE: $2,964.3627097-2
CPT CODE: $2,964.3627098-2
CPT CODE: $3,270.6627100-2
CPT CODE: $3,468.2727105-2
CPT CODE: $4,406.9427110-2
CPT CODE: $3,270.6627111-2
CPT CODE: $5,227.0827120-2
CPT CODE: $4,406.9427122-2
CPT CODE: $4,426.7327125-2
CPT CODE: $6,100.5827130-2
CPT CODE: $8,171.6827132-2
CPT CODE: $9,900.8827134-2
CPT CODE: $6,788.3527137-2
CPT CODE: $6,788.3527138-2
CPT CODE: $2,638.2627140-2
CPT CODE: $4,406.9427146-2
CPT CODE: $4,772.5627147-2
CPT CODE: $6,096.6527151-2
CPT CODE: $4,772.5627156-2
CPT CODE: $4,772.5627158-2
CPT CODE: $3,853.6727161-2
CPT CODE: $3,991.9527165-2
CPT CODE: $3,567.0927170-2
CPT CODE: $2,272.6727175-2
CPT CODE: $3,211.3427176-2
CPT CODE: $5,088.7827177-2
CPT CODE: $4,584.8627178-2
CPT CODE: $3,468.2727179-2
CPT CODE: $5,227.0827181-2
CPT CODE: $1,758.8427185-2
CPT CODE: $4,584.8627187-2
CPT CODE: $269.9327197-2
CPT CODE: $475.5427198-2
CPT CODE: $622.5027200-2
CPT CODE: $1,571.0927202-2
CPT CODE: $2,400.9327215-2
CPT CODE: $1,205.2627216-2
CPT CODE: $3,003.5527217-2
CPT CODE: $3,003.5527218-2
CPT CODE: $1,077.0327220-2
CPT CODE: $2,519.6927222-2
CPT CODE: $3,309.6427226-2
CPT CODE: $4,055.7727227-2
CPT CODE: $4,524.4727228-2
CPT CODE: $879.4127230-2
CPT CODE: $2,075.0227232-2
CPT CODE: $4,159.9527235-2
CPT CODE: $4,574.9427236-2
CPT CODE: $879.4127238-2
CPT CODE: $2,075.0227240-2
CPT CODE: $4,110.5327244-2
CPT CODE: $3,787.9327245-2
CPT CODE: $691.6927246-2
CPT CODE: $1,571.0927248-2
CPT CODE: $820.1327250-2
CPT CODE: $1,571.0927252-2
CPT CODE: $3,527.5327253-2
CPT CODE: $4,278.4927254-2
CPT CODE: $2,025.6127256-2
CPT CODE: $1,571.0927257-2
CPT CODE: $3,527.5327258-2
CPT CODE: $4,940.5727259-2
CPT CODE: $820.1327265-2
CPT CODE: $1,571.0927266-2
CPT CODE: $642.9027267-2
CPT CODE: $794.2627268-2
CPT CODE: $3,347.7927269-2
CPT CODE: $513.8327275-2
CPT CODE: $682.7727279-2
CPT CODE: $3,082.8927280-2
CPT CODE: $3,082.8927282-2
CPT CODE: $4,584.8627284-2
CPT CODE: $4,841.7427286-2
CPT CODE: $5,661.8827290-2
CPT CODE: $3,744.9327295-2
CPT CODE: $523.7027301-2
CPT CODE: $928.8227303-2
CPT CODE: $1,077.0327305-2
CPT CODE: $563.1927306-2
CPT CODE: $820.1327307-2
CPT CODE: $2,519.6927310-2
CPT CODE: $249.0127323-2
CPT CODE: $513.8327324-2
CPT CODE: $1,509.7627325-2
CPT CODE: $1,509.7627326-2
CPT CODE: $711.4427327-2
CPT CODE: $889.2827328-2
CPT CODE: $4,742.9327329-2
CPT CODE: $2,154.1027330-2
CPT CODE: $2,322.0527331-2
Page 10
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $2,697.5027332-2
CPT CODE: $3,270.6627333-2
CPT CODE: $2,302.3127334-2
CPT CODE: $3,774.5827335-2
CPT CODE: $703.6927337-2
CPT CODE: $1,269.7427339-2
CPT CODE: $1,017.7527340-2
CPT CODE: $1,887.2927345-2
CPT CODE: $1,328.8827347-2
CPT CODE: $1,986.0927350-2
CPT CODE: $2,134.3227355-2
CPT CODE: $2,707.4227356-2
CPT CODE: $3,270.6627357-2
CPT CODE: $563.1927358-2
CPT CODE: $2,134.3227360-2
CPT CODE: $3,441.2827364-2
CPT CODE: $3,774.5827365-2
CPT CODE: $43.2127369-2
CPT CODE: $820.1327372-2
CPT CODE: $2,203.4827380-2
CPT CODE: $2,203.4827381-2
CPT CODE: $2,638.2627385-2
CPT CODE: $3,468.2727386-2
CPT CODE: $1,077.0327390-2
CPT CODE: $1,571.0927391-2
CPT CODE: $2,401.0927392-2
CPT CODE: $1,324.0727393-2
CPT CODE: $1,758.8427394-2
CPT CODE: $2,638.2627395-2
CPT CODE: $3,270.6627396-2
CPT CODE: $3,774.5827397-2
CPT CODE: $3,468.2727400-2
CPT CODE: $2,569.1027403-2
CPT CODE: $2,905.0527405-2
CPT CODE: $3,201.4627407-2
CPT CODE: $3,744.9327409-2
CPT CODE: $3,552.9427412-2
CPT CODE: $3,561.5427415-2
CPT CODE: $3,712.5827416-2
CPT CODE: $3,715.2827418-2
CPT CODE: $3,270.6627420-2
CPT CODE: $3,270.6627422-2
CPT CODE: $3,270.6627424-2
CPT CODE: $2,756.8227425-2
CPT CODE: $3,379.3327427-2
CPT CODE: $4,327.9327428-2
CPT CODE: $4,505.7827429-2
CPT CODE: $3,270.6627430-2
CPT CODE: $1,827.9827435-2
CPT CODE: $2,786.4627437-2
CPT CODE: $5,167.8227438-2
CPT CODE: $4,100.6527440-2
CPT CODE: $5,533.4127441-2
CPT CODE: $5,414.8527442-2
CPT CODE: $7,302.1327443-2
CPT CODE: $5,414.8527445-2
CPT CODE: $6,165.8427446-2
CPT CODE: $6,153.9427447-2
CPT CODE: $3,142.1927448-2
CPT CODE: $4,090.7727450-2
CPT CODE: $4,406.9427454-2
CPT CODE: $2,519.6927455-2
CPT CODE: $3,082.8927457-2
CPT CODE: $3,468.2727465-2
CPT CODE: $3,774.5827466-2
CPT CODE: $5,088.7827468-2
CPT CODE: $4,406.9427470-2
CPT CODE: $5,088.7827472-2
CPT CODE: $2,826.0227475-2
CPT CODE: $2,826.0227477-2
CPT CODE: $3,468.2727479-2
CPT CODE: $2,401.0927485-2
CPT CODE: $7,252.7527486-2
CPT CODE: $7,302.1327487-2
CPT CODE: $1,254.9127488-2
CPT CODE: $4,159.9527495-2
CPT CODE: $841.8027496-2
CPT CODE: $1,080.9027497-2
CPT CODE: $1,080.9027498-2
CPT CODE: $1,320.0327499-2
CPT CODE: $1,156.0827500-2
CPT CODE: $1,080.9027501-2
CPT CODE: $2,272.6727502-2
CPT CODE: $2,171.3627503-2
CPT CODE: $3,893.1827506-2
CPT CODE: $3,969.6727507-2
CPT CODE: $879.4127508-2
CPT CODE: $1,683.5227509-2
CPT CODE: $1,748.9727510-2
CPT CODE: $3,969.6727511-2
CPT CODE: $3,969.6727513-2
CPT CODE: $3,853.6727514-2
CPT CODE: $691.6927516-2
CPT CODE: $1,571.0927517-2
CPT CODE: $3,270.6627519-2
CPT CODE: $839.9127520-2
CPT CODE: $2,272.6727524-2
CPT CODE: $691.6927530-2
CPT CODE: $1,462.3827532-2
CPT CODE: $2,888.7827535-2
CPT CODE: $3,231.1027536-2
CPT CODE: $1,106.7127538-2
CPT CODE: $3,082.8927540-2
CPT CODE: $1,077.0327550-2
CPT CODE: $1,077.0327552-2
CPT CODE: $3,082.8927556-2
CPT CODE: $3,082.8927557-2
CPT CODE: $2,946.1627558-2
CPT CODE: $464.3827560-2
CPT CODE: $444.6527562-2
CPT CODE: $2,638.2627566-2
CPT CODE: $464.3827570-2
CPT CODE: $3,853.6727580-2
CPT CODE: $3,013.7427590-2
CPT CODE: $2,776.6027591-2
CPT CODE: $2,826.0227592-2
CPT CODE: $691.6927594-2
CPT CODE: $1,017.7527596-2
CPT CODE: $2,717.3027598-2
CPT CODE: $928.8227600-2
CPT CODE: $1,037.5027601-2
CPT CODE: $1,383.3327602-2
CPT CODE: $1,393.2127603-2
CPT CODE: $1,393.2127604-2
CPT CODE: $313.0227605-2
CPT CODE: $563.1927606-2
CPT CODE: $938.6827607-2
CPT CODE: $2,005.8827610-2
CPT CODE: $1,936.7027612-2
CPT CODE: $249.0127613-2
CPT CODE: $513.8327614-2
CPT CODE: $4,742.9327615-2
CPT CODE: $2,675.8427616-2
CPT CODE: $810.2627618-2
CPT CODE: $1,165.9427619-2
CPT CODE: $1,936.7027620-2
CPT CODE: $1,926.8027625-2
CPT CODE: $2,351.7227626-2
CPT CODE: $760.8327630-2
CPT CODE: $695.9827632-2
CPT CODE: $1,141.1027634-2
CPT CODE: $1,936.7027635-2
CPT CODE: $2,727.2027637-2
CPT CODE: $2,826.0227638-2
CPT CODE: $2,351.7227640-2
CPT CODE: $1,383.3327641-2
CPT CODE: $3,300.2727645-2
CPT CODE: $1,739.0927646-2
CPT CODE: $1,383.3327647-2
CPT CODE: $124.5027648-2
CPT CODE: $2,322.0527650-2
CPT CODE: $2,924.8327652-2
Page 11
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $2,816.0927654-2
CPT CODE: $1,324.0727656-2
CPT CODE: $1,383.3327658-2
CPT CODE: $1,571.0927659-2
CPT CODE: $1,383.3327664-2
CPT CODE: $1,758.8427665-2
CPT CODE: $1,324.0727675-2
CPT CODE: $1,324.0727676-2
CPT CODE: $1,027.6527680-2
CPT CODE: $1,324.0727681-2
CPT CODE: $1,482.1527685-2
CPT CODE: $1,758.8427686-2
CPT CODE: $1,571.0927687-2
CPT CODE: $1,758.8427690-2
CPT CODE: $2,193.6227691-2
CPT CODE: $563.1927692-2
CPT CODE: $2,193.6227695-2
CPT CODE: $3,082.8927696-2
CPT CODE: $2,588.8727698-2
CPT CODE: $3,774.5827700-2
CPT CODE: $6,096.6527702-2
CPT CODE: $6,333.8027703-2
CPT CODE: $731.2127704-2
CPT CODE: $2,381.3227705-2
CPT CODE: $1,383.3327707-2
CPT CODE: $3,774.5827709-2
CPT CODE: $3,774.5827712-2
CPT CODE: $5,227.0827715-2
CPT CODE: $3,270.6627720-2
CPT CODE: $3,774.5827722-2
CPT CODE: $3,853.6727724-2
CPT CODE: $3,774.5827725-2
CPT CODE: $2,393.1227726-2
CPT CODE: $2,697.5027727-2
CPT CODE: $2,203.4827730-2
CPT CODE: $1,324.0727732-2
CPT CODE: $2,717.3027734-2
CPT CODE: $3,962.2927740-2
CPT CODE: $4,772.5627742-2
CPT CODE: $3,596.7127745-2
CPT CODE: $1,175.8627750-2
CPT CODE: $1,511.8127752-2
CPT CODE: $2,588.8727756-2
CPT CODE: $2,826.0227758-2
CPT CODE: $3,242.7027759-2
CPT CODE: $889.2827760-2
CPT CODE: $997.9827762-2
CPT CODE: $2,124.4027766-2
CPT CODE: $496.7427767-2
CPT CODE: $623.5127768-2
CPT CODE: $1,459.1627769-2
CPT CODE: $770.7327780-2
CPT CODE: $770.7327781-2
CPT CODE: $1,422.8927784-2
CPT CODE: $681.8127786-2
CPT CODE: $849.7727788-2
CPT CODE: $1,995.9927792-2
CPT CODE: $1,363.6027808-2
CPT CODE: $1,551.3427810-2
CPT CODE: $2,806.2227814-2
CPT CODE: $879.4127816-2
CPT CODE: $1,758.8427818-2
CPT CODE: $2,993.9527822-2
CPT CODE: $3,171.8327823-2
CPT CODE: $841.8027824-2
CPT CODE: $1,683.5227825-2
CPT CODE: $3,003.5527826-2
CPT CODE: $3,003.5527827-2
CPT CODE: $3,127.9027828-2
CPT CODE: $2,037.4527829-2
CPT CODE: $622.5027830-2
CPT CODE: $760.8327831-2
CPT CODE: $1,758.8427832-2
CPT CODE: $622.5027840-2
CPT CODE: $760.8327842-2
CPT CODE: $2,134.3227846-2
CPT CODE: $1,758.8427848-2
CPT CODE: $444.6527860-2
CPT CODE: $3,379.3327870-2
CPT CODE: $3,774.5827871-2
CPT CODE: $2,588.8727880-2
CPT CODE: $2,826.0227881-2
CPT CODE: $1,887.2927882-2
CPT CODE: $563.1927884-2
CPT CODE: $1,254.9127886-2
CPT CODE: $2,193.6227888-2
CPT CODE: $2,588.8727889-2
CPT CODE: $1,023.5027892-2
CPT CODE: $1,023.5027893-2
CPT CODE: $1,320.0327894-2
CPT CODE: $543.4628001-2
CPT CODE: $780.6028002-2
CPT CODE: $810.2628003-2
CPT CODE: $1,254.9128005-2
CPT CODE: $780.6028008-2
CPT CODE: $124.5028010-2
CPT CODE: $316.2128011-2
CPT CODE: $1,294.4128020-2
CPT CODE: $642.2728022-2
CPT CODE: $563.1928024-2
CPT CODE: $1,758.8428035-2
CPT CODE: $801.4728039-2
CPT CODE: $769.3128041-2
CPT CODE: $573.0828043-2
CPT CODE: $760.8328045-2
CPT CODE: $899.1628046-2
CPT CODE: $1,645.3828047-2
CPT CODE: $1,324.0728050-2
CPT CODE: $820.1328052-2
CPT CODE: $563.1928054-2
CPT CODE: $1,119.8428055-2
CPT CODE: $928.8228060-2
CPT CODE: $938.6828062-2
CPT CODE: $1,324.0728070-2
CPT CODE: $820.1328072-2
CPT CODE: $1,156.0828080-2
CPT CODE: $1,383.3328086-2
CPT CODE: $1,077.0328088-2
CPT CODE: $830.0228090-2
CPT CODE: $780.6028092-2
CPT CODE: $1,324.0728100-2
CPT CODE: $1,571.0928102-2
CPT CODE: $1,571.0928103-2
CPT CODE: $1,077.0328104-2
CPT CODE: $1,324.0728106-2
CPT CODE: $1,324.0728107-2
CPT CODE: $997.9828108-2
CPT CODE: $563.1928110-2
CPT CODE: $1,571.0928111-2
CPT CODE: $879.4128112-2
CPT CODE: $879.4128113-2
CPT CODE: $1,739.0928114-2
CPT CODE: $1,571.0928116-2
CPT CODE: $1,077.0328118-2
CPT CODE: $1,165.9428119-2
CPT CODE: $1,324.0728120-2
CPT CODE: $1,294.4128122-2
CPT CODE: $820.1328124-2
CPT CODE: $1,067.1528126-2
CPT CODE: $2,203.4828130-2
CPT CODE: $968.3428140-2
CPT CODE: $879.4128150-2
CPT CODE: $889.2828153-2
CPT CODE: $770.7328160-2
CPT CODE: $1,571.0928171-2
CPT CODE: $1,254.9128173-2
CPT CODE: $820.1328175-2
CPT CODE: $156.1228190-2
CPT CODE: $642.2728192-2
CPT CODE: $1,324.0728193-2
CPT CODE: $1,324.0728200-2
CPT CODE: $1,758.8428202-2
Page 12
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $622.5028208-2
CPT CODE: $938.6828210-2
CPT CODE: $1,077.0328220-2
CPT CODE: $1,343.8228222-2
CPT CODE: $622.5028225-2
CPT CODE: $820.1328226-2
CPT CODE: $642.2728230-2
CPT CODE: $316.2128232-2
CPT CODE: $251.0028234-2
CPT CODE: $1,571.0928238-2
CPT CODE: $820.1328240-2
CPT CODE: $948.6128250-2
CPT CODE: $1,887.2928260-2
CPT CODE: $2,025.6128261-2
CPT CODE: $3,033.4928262-2
CPT CODE: $2,401.0928264-2
CPT CODE: $671.9228270-2
CPT CODE: $671.9228272-2
CPT CODE: $780.6028280-2
CPT CODE: $978.2328285-2
CPT CODE: $770.7328286-2
CPT CODE: $563.1928288-2
CPT CODE: $986.6928289-2
CPT CODE: $986.6828291-2
CPT CODE: $1,561.2328292-2
CPT CODE: $593.9328295-2
CPT CODE: $1,946.5728296-2
CPT CODE: $1,867.4828297-2
CPT CODE: $1,887.2928298-2
CPT CODE: $1,571.0928299-2
CPT CODE: $2,075.0228300-2
CPT CODE: $1,936.7028302-2
CPT CODE: $1,758.8428304-2
CPT CODE: $1,936.7028305-2
CPT CODE: $1,580.9628306-2
CPT CODE: $1,739.0928307-2
CPT CODE: $1,254.9128308-2
CPT CODE: $1,936.7028309-2
CPT CODE: $691.6928310-2
CPT CODE: $444.6528312-2
CPT CODE: $820.1328313-2
CPT CODE: $1,165.9428315-2
CPT CODE: $1,195.5928320-2
CPT CODE: $1,027.6528322-2
CPT CODE: $1,077.0328340-2
CPT CODE: $1,511.8128341-2
CPT CODE: $1,077.0328344-2
CPT CODE: $1,571.0928345-2
CPT CODE: $2,697.5028360-2
CPT CODE: $632.3928400-2
CPT CODE: $1,165.9428405-2
CPT CODE: $1,887.2928406-2
CPT CODE: $2,163.9528415-2
CPT CODE: $2,371.4428420-2
CPT CODE: $642.2728430-2
CPT CODE: $1,165.9428435-2
CPT CODE: $1,887.2928436-2
CPT CODE: $2,519.6928445-2
CPT CODE: $2,817.4228446-2
CPT CODE: $503.9528450-2
CPT CODE: $760.8328455-2
CPT CODE: $1,096.7828456-2
CPT CODE: $1,195.5928465-2
CPT CODE: $523.7028470-2
CPT CODE: $671.9228475-2
CPT CODE: $892.7128476-2
CPT CODE: $1,146.2328485-2
CPT CODE: $205.5228490-2
CPT CODE: $326.0728495-2
CPT CODE: $1,096.7828496-2
CPT CODE: $582.9828505-2
CPT CODE: $306.3028510-2
CPT CODE: $306.3028515-2
CPT CODE: $582.9828525-2
CPT CODE: $306.3028530-2
CPT CODE: $660.0028531-2
CPT CODE: $503.9528540-2
CPT CODE: $622.5028545-2
CPT CODE: $691.6928546-2
CPT CODE: $1,571.0928555-2
CPT CODE: $820.1328570-2
CPT CODE: $820.1328575-2
CPT CODE: $717.4228576-2
CPT CODE: $1,887.2928585-2
CPT CODE: $207.4828600-2
CPT CODE: $513.8328605-2
CPT CODE: $691.6928606-2
CPT CODE: $1,254.9128615-2
CPT CODE: $146.2628630-2
CPT CODE: $316.2128635-2
CPT CODE: $306.0928636-2
CPT CODE: $879.4128645-2
CPT CODE: $124.5028660-2
CPT CODE: $185.7728665-2
CPT CODE: $177.9328666-2
CPT CODE: $622.5028675-2
CPT CODE: $4,100.6528705-2
CPT CODE: $2,964.3628715-2
CPT CODE: $2,460.3928725-2
CPT CODE: $2,401.0928730-2
CPT CODE: $1,936.7028735-2
CPT CODE: $1,521.7128737-2
CPT CODE: $879.4128740-2
CPT CODE: $1,571.0928750-2
CPT CODE: $879.4128755-2
CPT CODE: $1,324.0728760-2
CPT CODE: $1,877.4028800-2
CPT CODE: $1,887.2928805-2
CPT CODE: $1,146.2328810-2
CPT CODE: $592.8728820-2
CPT CODE: $622.5028825-2
CPT CODE: $487.6428890-2
CPT CODE: $691.6929000-2
CPT CODE: $691.6929010-2
CPT CODE: $820.1329015-2
CPT CODE: $523.7029035-2
CPT CODE: $820.1329040-2
CPT CODE: $622.5029044-2
CPT CODE: $691.6929046-2
CPT CODE: $124.5029049-2
CPT CODE: $365.5829055-2
CPT CODE: $187.7329058-2
CPT CODE: $251.0029065-2
CPT CODE: $174.3129075-2
CPT CODE: $175.8629085-2
CPT CODE: $57.0829086-2
CPT CODE: $215.3929105-2
CPT CODE: $69.1529125-2
CPT CODE: $96.8429126-2
CPT CODE: $65.2029130-2
CPT CODE: $59.2829131-2
CPT CODE: $75.1129200-2
CPT CODE: $73.1029240-2
CPT CODE: $71.1629260-2
CPT CODE: $51.3829280-2
CPT CODE: $543.4629305-2
CPT CODE: $642.2729325-2
CPT CODE: $274.6829345-2
CPT CODE: $294.4729355-2
CPT CODE: $563.1929358-2
CPT CODE: $306.3029365-2
CPT CODE: $239.1329405-2
CPT CODE: $245.0629425-2
CPT CODE: $296.4329435-2
CPT CODE: $49.3929440-2
CPT CODE: $272.3529445-2
CPT CODE: $106.7229450-2
CPT CODE: $148.2029505-2
CPT CODE: $110.6729515-2
CPT CODE: $187.7329520-2
CPT CODE: $98.8129530-2
CPT CODE: $75.1129540-2
Page 13
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $63.2129550-2
CPT CODE: $106.7229580-2
CPT CODE: $146.6629581-2
CPT CODE: $138.1429584-2
CPT CODE: $120.5329700-2
CPT CODE: $71.1629705-2
CPT CODE: $124.5029710-2
CPT CODE: $88.9129720-2
CPT CODE: $120.5329730-2
CPT CODE: $124.5029740-2
CPT CODE: $124.5029750-2
CPT CODE: $1,363.6029800-2
CPT CODE: $2,717.3029804-2
CPT CODE: $1,297.4629805-2
CPT CODE: $3,154.9329806-2
CPT CODE: $3,574.5729807-2
CPT CODE: $3,567.0929819-2
CPT CODE: $2,509.7929820-2
CPT CODE: $3,567.0929821-2
CPT CODE: $2,509.7929822-2
CPT CODE: $3,567.0929823-2
CPT CODE: $1,103.0729824-2
CPT CODE: $3,567.0929825-2
CPT CODE: $3,210.3829826-2
CPT CODE: $2,509.6029827-2
CPT CODE: $1,307.8129828-2
CPT CODE: $1,521.7129830-2
CPT CODE: $3,656.0129834-2
CPT CODE: $2,569.1029835-2
CPT CODE: $3,656.0129836-2
CPT CODE: $2,569.1029837-2
CPT CODE: $3,656.0129838-2
CPT CODE: $1,511.8129840-2
CPT CODE: $2,460.3929843-2
CPT CODE: $2,875.3929844-2
CPT CODE: $3,418.8929845-2
CPT CODE: $3,468.2729846-2
CPT CODE: $2,638.2629847-2
CPT CODE: $1,314.1729848-2
CPT CODE: $2,946.1629850-2
CPT CODE: $2,946.1629851-2
CPT CODE: $2,888.7829855-2
CPT CODE: $2,888.7829856-2
CPT CODE: $1,773.8129860-2
CPT CODE: $4,253.7829861-2
CPT CODE: $3,491.8629862-2
CPT CODE: $3,912.4929863-2
CPT CODE: $4,111.6729866-2
CPT CODE: $3,561.5429867-2
CPT CODE: $3,561.5429868-2
CPT CODE: $1,294.4129870-2
CPT CODE: $2,312.1729871-2
CPT CODE: $1,954.7629873-2
CPT CODE: $3,567.0929874-2
CPT CODE: $2,694.5429875-2
CPT CODE: $3,300.2729876-2
CPT CODE: $2,970.2329877-2
CPT CODE: $3,300.2729879-2
CPT CODE: $3,895.1429880-2
CPT CODE: $2,970.2329881-2
CPT CODE: $3,300.2729882-2
CPT CODE: $4,268.6629883-2
CPT CODE: $3,300.2729884-2
CPT CODE: $3,300.2729885-2
CPT CODE: $2,312.1729886-2
CPT CODE: $3,300.2729887-2
CPT CODE: $5,291.3229888-2
CPT CODE: $5,879.2729889-2
CPT CODE: $3,152.3029891-2
CPT CODE: $3,152.3029892-2
CPT CODE: $736.5529893-2
CPT CODE: $3,567.0929894-2
CPT CODE: $2,509.7929895-2
CPT CODE: $2,509.7929897-2
CPT CODE: $3,567.0929898-2
CPT CODE: $2,874.9929899-2
CPT CODE: $663.3829900-2
CPT CODE: $732.8229901-2
CPT CODE: $833.0829902-2
CPT CODE: $1,275.4829904-2
CPT CODE: $1,469.5129905-2
CPT CODE: $1,469.5129906-2
CPT CODE: $1,199.1529907-2
CPT CODE: $1,938.8129914-2
CPT CODE: $1,975.4629915-2
CPT CODE: $1,975.8429916-2
CPT CODE: $316.2130000-2
CPT CODE: $296.4330020-2
CPT CODE: $185.7730100-2
CPT CODE: $258.8930110-2
CPT CODE: $938.6830115-2
CPT CODE: $889.2830117-2
CPT CODE: $1,452.5030118-2
CPT CODE: $2,272.6730120-2
CPT CODE: $523.7030124-2
CPT CODE: $938.6830125-2
CPT CODE: $622.5030130-2
CPT CODE: $1,511.8130140-2
CPT CODE: $2,401.0930150-2
CPT CODE: $3,596.7130160-2
CPT CODE: $51.3830200-2
CPT CODE: $71.1630210-2
CPT CODE: $2,480.1430220-2
CPT CODE: $104.7330300-2
CPT CODE: $652.1930310-2
CPT CODE: $683.4230320-2
CPT CODE: $2,588.8730400-2
CPT CODE: $3,725.1830410-2
CPT CODE: $4,199.4530420-2
CPT CODE: $563.1930430-2
CPT CODE: $879.4130435-2
CPT CODE: $2,519.6930450-2
CPT CODE: $545.2530460-2
CPT CODE: $1,511.3530462-2
CPT CODE: $1,147.9630465-2
CPT CODE: $3,142.1930520-2
CPT CODE: $2,401.0930540-2
CPT CODE: $4,525.5530545-2
CPT CODE: $124.5030560-2
CPT CODE: $2,272.6730580-2
CPT CODE: $1,294.4130600-2
CPT CODE: $2,480.1430620-2
CPT CODE: $2,569.1030630-2
CPT CODE: $185.7730801-2
CPT CODE: $405.1130802-2
CPT CODE: $128.4430901-2
CPT CODE: $229.2630903-2
CPT CODE: $474.2730905-2
CPT CODE: $444.6530906-2
CPT CODE: $1,571.0930915-2
CPT CODE: $1,620.4930920-2
CPT CODE: $102.7631000-2
CPT CODE: $444.6531002-2
CPT CODE: $928.8231020-2
CPT CODE: $2,242.9931030-2
CPT CODE: $2,588.8731032-2
CPT CODE: $1,660.0431040-2
CPT CODE: $1,660.0431050-2
CPT CODE: $1,827.9831051-2
CPT CODE: $1,758.8431070-2
CPT CODE: $2,885.2731075-2
CPT CODE: $2,826.0231080-2
CPT CODE: $2,826.0231081-2
CPT CODE: $3,774.5831084-2
CPT CODE: $3,774.5831085-2
CPT CODE: $3,774.5831086-2
CPT CODE: $3,774.5831087-2
CPT CODE: $4,090.7731090-2
CPT CODE: $1,452.5031200-2
CPT CODE: $1,768.7231201-2
CPT CODE: $6,096.6531230-2
CPT CODE: $259.4431231-2
Page 14
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $699.9231235-2
CPT CODE: $681.2631237-2
CPT CODE: $401.2931238-2
CPT CODE: $2,566.3631239-2
CPT CODE: $1,511.8131240-2
CPT CODE: $471.1731241-2
CPT CODE: $975.5631253-2
CPT CODE: $1,416.1631254-2
CPT CODE: $1,724.8131255-2
CPT CODE: $1,152.8931256-2
CPT CODE: $975.5631257-2
CPT CODE: $975.5631259-2
CPT CODE: $1,216.4531267-2
CPT CODE: $2,559.9831276-2
CPT CODE: $1,735.7831287-2
CPT CODE: $1,735.7831288-2
CPT CODE: $5,142.0431290-2
CPT CODE: $5,142.0431291-2
CPT CODE: $3,975.4831292-2
CPT CODE: $4,348.7631293-2
CPT CODE: $4,974.0531294-2
CPT CODE: $2,645.2931295-2
CPT CODE: $4,921.5931296-2
CPT CODE: $4,867.7531297-2
CPT CODE: $4,584.8631300-2
CPT CODE: $4,584.8631360-2
CPT CODE: $5,019.6231365-2
CPT CODE: $4,584.8631367-2
CPT CODE: $5,355.5731368-2
CPT CODE: $5,661.8831370-2
CPT CODE: $4,584.8631375-2
CPT CODE: $4,584.8631380-2
CPT CODE: $4,584.8631382-2
CPT CODE: $7,687.5231390-2
CPT CODE: $8,685.4731395-2
CPT CODE: $4,525.5531400-2
CPT CODE: $3,527.5331420-2
CPT CODE: $365.5831500-2
CPT CODE: $241.1131502-2
CPT CODE: $185.7731510-2
CPT CODE: $365.5831511-2
CPT CODE: $365.5831512-2
CPT CODE: $365.5831513-2
CPT CODE: $543.4631515-2
CPT CODE: $199.5931520-2
CPT CODE: $652.1931525-2
CPT CODE: $1,165.9431526-2
CPT CODE: $1,452.5031527-2
CPT CODE: $622.5031528-2
CPT CODE: $444.6531529-2
CPT CODE: $1,027.6531530-2
CPT CODE: $928.8231531-2
CPT CODE: $928.8231535-2
CPT CODE: $1,165.9431536-2
CPT CODE: $1,215.3831540-2
CPT CODE: $1,827.9831541-2
CPT CODE: $1,853.8331545-2
CPT CODE: $2,224.8831546-2
CPT CODE: $1,550.5831551-2
CPT CODE: $1,564.3731552-2
CPT CODE: $1,704.5631553-2
CPT CODE: $1,791.6931554-2
CPT CODE: $3,339.8231560-2
CPT CODE: $3,339.8231561-2
CPT CODE: $928.8231570-2
CPT CODE: $928.8231571-2
CPT CODE: $198.6631572-2
CPT CODE: $163.7731573-2
CPT CODE: $163.7731574-2
CPT CODE: $513.8331575-2
CPT CODE: $938.6831576-2
CPT CODE: $1,254.9131577-2
CPT CODE: $938.6831578-2
CPT CODE: $938.6831579-2
CPT CODE: $4,584.8631580-2
CPT CODE: $4,584.8631584-2
CPT CODE: $4,584.8631587-2
CPT CODE: $2,272.6731590-2
CPT CODE: $1,129.6831591-2
CPT CODE: $1,836.9731592-2
CPT CODE: $1,086.9431600-2
CPT CODE: $1,383.3331601-2
CPT CODE: $1,383.3331603-2
CPT CODE: $2,075.0231605-2
CPT CODE: $2,885.2731610-2
CPT CODE: $1,571.0931611-2
CPT CODE: $622.5031612-2
CPT CODE: $711.4431613-2
CPT CODE: $1,432.7731614-2
CPT CODE: $770.7331615-2
CPT CODE: $770.7331622-2
CPT CODE: $715.9531623-2
CPT CODE: $715.9531624-2
CPT CODE: $830.0231625-2
CPT CODE: $630.3631626-2
CPT CODE: $1,289.0331627-2
CPT CODE: $830.0231628-2
CPT CODE: $830.0231629-2
CPT CODE: $711.4431630-2
CPT CODE: $711.4431631-2
CPT CODE: $174.1231632-2
CPT CODE: $218.3931633-2
CPT CODE: $2,371.1331634-2
CPT CODE: $573.0531636-2
CPT CODE: $169.0531637-2
CPT CODE: $573.0531638-2
CPT CODE: $1,037.5031640-2
CPT CODE: $1,373.4631641-2
CPT CODE: $664.4431643-2
CPT CODE: $780.6031645-2
CPT CODE: $780.6031646-2
CPT CODE: $270.9631647-2
CPT CODE: $281.6931648-2
CPT CODE: $90.6231649-2
CPT CODE: $96.2431651-2
CPT CODE: $438.9631652-2
CPT CODE: $293.8531653-2
CPT CODE: $77.0431654-2
CPT CODE: $271.2831660-2
CPT CODE: $286.4931661-2
CPT CODE: $187.7331717-2
CPT CODE: $187.7331720-2
CPT CODE: $251.0031725-2
CPT CODE: $1,434.8231730-2
CPT CODE: $3,142.1931750-2
CPT CODE: $1,571.0931755-2
CPT CODE: $4,723.1731760-2
CPT CODE: $3,191.6031766-2
CPT CODE: $3,191.6031770-2
CPT CODE: $3,191.6031775-2
CPT CODE: $3,191.6031780-2
CPT CODE: $3,191.6031781-2
CPT CODE: $3,191.6031785-2
CPT CODE: $3,191.6031786-2
CPT CODE: $2,272.6731800-2
CPT CODE: $4,584.8631805-2
CPT CODE: $938.6831820-2
CPT CODE: $1,077.0331825-2
CPT CODE: $1,077.0331830-2
CPT CODE: $1,610.6032035-2
CPT CODE: $2,025.6132036-2
CPT CODE: $1,086.8932096-2
CPT CODE: $1,086.8932097-2
CPT CODE: $914.8332098-2
CPT CODE: $3,497.9032100-2
CPT CODE: $2,816.0932110-2
CPT CODE: $2,885.2732120-2
CPT CODE: $2,885.2732124-2
CPT CODE: $4,011.7332140-2
CPT CODE: $4,011.7332141-2
CPT CODE: $2,885.2732150-2
CPT CODE: $3,013.7432151-2
Page 15
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $2,885.2732160-2
CPT CODE: $3,013.7432200-2
CPT CODE: $2,885.2732215-2
CPT CODE: $4,406.9432220-2
CPT CODE: $2,885.2732225-2
CPT CODE: $5,355.5732320-2
CPT CODE: $249.0132400-2
CPT CODE: $249.0132405-2
CPT CODE: $5,167.8232440-2
CPT CODE: $6,765.7832442-2
CPT CODE: $5,167.8232445-2
CPT CODE: $4,901.0432480-2
CPT CODE: $4,899.3832482-2
CPT CODE: $4,899.3832484-2
CPT CODE: $6,495.1932486-2
CPT CODE: $4,899.3832488-2
CPT CODE: $4,134.7432491-2
CPT CODE: $1,341.8432501-2
CPT CODE: $3,974.2032503-2
CPT CODE: $4,701.5432504-2
CPT CODE: $1,725.3032505-2
CPT CODE: $290.5532506-2
CPT CODE: $290.5532507-2
CPT CODE: $4,209.3432540-2
CPT CODE: $525.2032550-2
CPT CODE: $477.3332551-2
CPT CODE: $292.0332552-2
CPT CODE: $769.3132553-2
CPT CODE: $183.0632554-2
CPT CODE: $229.5232555-2
CPT CODE: $321.2432556-2
CPT CODE: $324.7832557-2
CPT CODE: $161.7032560-2
CPT CODE: $131.2232561-2
CPT CODE: $117.7132562-2
CPT CODE: $1,073.2032601-2
CPT CODE: $1,119.8632604-2
CPT CODE: $1,119.8632606-2
CPT CODE: $508.9132607-2
CPT CODE: $625.0432608-2
CPT CODE: $432.2332609-2
CPT CODE: $2,883.6332650-2
CPT CODE: $2,883.6332651-2
CPT CODE: $4,395.4532652-2
CPT CODE: $2,883.6332653-2
CPT CODE: $2,818.3032654-2
CPT CODE: $4,003.4732655-2
CPT CODE: $4,162.1532656-2
CPT CODE: $3,844.8532658-2
CPT CODE: $3,816.8432659-2
CPT CODE: $3,844.8532661-2
CPT CODE: $5,067.3532662-2
CPT CODE: $4,899.3832663-2
CPT CODE: $3,471.5632664-2
CPT CODE: $3,770.1832665-2
CPT CODE: $1,422.1032666-2
CPT CODE: $256.3732667-2
CPT CODE: $257.5032668-2
CPT CODE: $2,190.7432669-2
CPT CODE: $2,615.8732670-2
CPT CODE: $3,578.1432671-2
CPT CODE: $2,481.5532672-2
CPT CODE: $1,921.2932673-2
CPT CODE: $351.7932674-2
CPT CODE: $258.1032701-2
CPT CODE: $3,497.9032800-2
CPT CODE: $1,867.4832810-2
CPT CODE: $3,497.9032815-2
CPT CODE: $2,136.2832820-2
CPT CODE: $9,397.4732851-2
CPT CODE: $9,397.4732852-2
CPT CODE: $11,263.9232853-2
CPT CODE: $11,263.9232854-2
CPT CODE: $3,013.7432900-2
CPT CODE: $2,885.2732905-2
CPT CODE: $4,090.7732906-2
CPT CODE: $3,013.7432940-2
CPT CODE: $444.6532960-2
CPT CODE: $697.1132997-2
CPT CODE: $246.1433016-2
CPT CODE: $255.7333017-2
CPT CODE: $292.6433018-2
CPT CODE: $236.8533019-2
CPT CODE: $3,843.7433020-2
CPT CODE: $3,814.1033025-2
CPT CODE: $6,738.9033030-2
CPT CODE: $9,564.9233031-2
CPT CODE: $3,843.7433050-2
CPT CODE: $8,428.5733120-2
CPT CODE: $4,723.1733130-2
CPT CODE: $5,235.6333140-2
CPT CODE: $2,278.8033202-2
CPT CODE: $2,278.8033203-2
CPT CODE: $2,035.5133206-2
CPT CODE: $2,035.5133207-2
CPT CODE: $3,073.0233208-2
CPT CODE: $879.4133210-2
CPT CODE: $877.2133211-2
CPT CODE: $879.4133212-2
CPT CODE: $877.2133213-2
CPT CODE: $1,213.1733214-2
CPT CODE: $887.1633215-2
CPT CODE: $2,035.5133216-2
CPT CODE: $2,034.4133217-2
CPT CODE: $1,037.5033218-2
CPT CODE: $1,035.8833220-2
CPT CODE: $1,056.6033221-2
CPT CODE: $731.2133222-2
CPT CODE: $727.9133223-2
CPT CODE: $1,076.6233224-2
CPT CODE: $1,076.6233225-2
CPT CODE: $1,033.0233226-2
CPT CODE: $650.6833227-2
CPT CODE: $650.6833228-2
CPT CODE: $650.6833229-2
CPT CODE: $1,275.9233230-2
CPT CODE: $1,275.9233231-2
CPT CODE: $989.2033233-2
CPT CODE: $989.2033234-2
CPT CODE: $989.2033235-2
CPT CODE: $989.2033236-2
CPT CODE: $989.2033237-2
CPT CODE: $1,586.4633238-2
CPT CODE: $877.2133240-2
CPT CODE: $877.2133241-2
CPT CODE: $2,211.7433243-2
CPT CODE: $2,211.7433244-2
CPT CODE: $5,216.6833249-2
CPT CODE: $7,055.1333250-2
CPT CODE: $8,428.5733251-2
CPT CODE: $5,024.4333254-2
CPT CODE: $5,414.3633255-2
CPT CODE: $6,016.1033256-2
CPT CODE: $2,099.4833257-2
CPT CODE: $2,122.7733258-2
CPT CODE: $2,589.7433259-2
CPT CODE: $8,428.5733261-2
CPT CODE: $615.5433262-2
CPT CODE: $615.5433263-2
CPT CODE: $615.5433264-2
CPT CODE: $5,024.4333265-2
CPT CODE: $5,715.2433266-2
CPT CODE: $748.9733270-2
CPT CODE: $588.1233271-2
CPT CODE: $492.9333272-2
CPT CODE: $475.3433273-2
CPT CODE: $92.3633285-2
CPT CODE: $90.6233286-2
CPT CODE: $3,814.1033300-2
CPT CODE: $6,738.9033305-2
CPT CODE: $4,841.7433310-2
CPT CODE: $7,677.6233315-2
Page 16
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $3,843.7433320-2
CPT CODE: $6,744.9433321-2
CPT CODE: $6,738.9033322-2
CPT CODE: $6,738.9033330-2
CPT CODE: $9,624.2033335-2
CPT CODE: $1,577.8333361-2
CPT CODE: $1,726.0933362-2
CPT CODE: $1,787.2333363-2
CPT CODE: $1,901.0533364-2
CPT CODE: $2,075.6833365-2
CPT CODE: $2,198.6533366-2
CPT CODE: $729.2833367-2
CPT CODE: $883.7133368-2
CPT CODE: $1,166.9233369-2
CPT CODE: $2,359.3133390-2
CPT CODE: $3,622.8333391-2
CPT CODE: $7,677.6233404-2
CPT CODE: $8,398.9633405-2
CPT CODE: $8,398.9433406-2
CPT CODE: $7,684.4233410-2
CPT CODE: $8,398.9633411-2
CPT CODE: $8,398.9633412-2
CPT CODE: $12,225.1233413-2
CPT CODE: $7,671.0233414-2
CPT CODE: $7,677.6233415-2
CPT CODE: $7,671.0233416-2
CPT CODE: $7,677.6233417-2
CPT CODE: $2,117.2933418-2
CPT CODE: $624.5933419-2
CPT CODE: $5,790.3333420-2
CPT CODE: $8,023.4633422-2
CPT CODE: $8,784.3133425-2
CPT CODE: $8,784.3133426-2
CPT CODE: $8,784.3133427-2
CPT CODE: $9,831.6933430-2
CPT CODE: $3,517.2533440-2
CPT CODE: $8,428.5733460-2
CPT CODE: $8,426.9433463-2
CPT CODE: $8,426.9433464-2
CPT CODE: $9,624.2033465-2
CPT CODE: $10,375.1533468-2
CPT CODE: $6,165.8433470-2
CPT CODE: $6,159.2033471-2
CPT CODE: $7,677.6233474-2
CPT CODE: $7,671.0233475-2
CPT CODE: $8,478.0133476-2
CPT CODE: $1,460.5633477-2
CPT CODE: $9,248.7133478-2
CPT CODE: $5,887.3533496-2
CPT CODE: $6,738.9033500-2
CPT CODE: $6,437.5433501-2
CPT CODE: $4,841.7433502-2
CPT CODE: $6,738.9033503-2
CPT CODE: $9,624.2033504-2
CPT CODE: $9,612.1233505-2
CPT CODE: $9,612.1233506-2
CPT CODE: $6,492.3533507-2
CPT CODE: $7,746.7633510-2
CPT CODE: $7,993.8333511-2
CPT CODE: $8,379.1733512-2
CPT CODE: $8,774.4433513-2
CPT CODE: $9,041.2133514-2
CPT CODE: $9,298.1133516-2
CPT CODE: $344.3733517-2
CPT CODE: $707.8433518-2
CPT CODE: $1,033.0833519-2
CPT CODE: $1,291.3533521-2
CPT CODE: $1,549.6133522-2
CPT CODE: $1,549.6133523-2
CPT CODE: $1,719.3033530-2
CPT CODE: $7,728.8733533-2
CPT CODE: $7,968.0333534-2
CPT CODE: $8,350.6333535-2
CPT CODE: $8,752.3733536-2
CPT CODE: $9,564.9233542-2
CPT CODE: $11,511.4733545-2
CPT CODE: $2,133.3433572-2
CPT CODE: $5,785.9233600-2
CPT CODE: $5,785.9233602-2
CPT CODE: $5,785.9233606-2
CPT CODE: $5,804.6033608-2
CPT CODE: $9,238.8433610-2
CPT CODE: $11,497.2233611-2
CPT CODE: $11,497.2233612-2
CPT CODE: $8,426.9433615-2
CPT CODE: $8,426.9433617-2
CPT CODE: $15,332.7233619-2
CPT CODE: $2,977.0333620-2
CPT CODE: $1,606.6933621-2
CPT CODE: $6,745.7933622-2
CPT CODE: $6,926.6633641-2
CPT CODE: $7,677.6233645-2
CPT CODE: $11,550.9933647-2
CPT CODE: $9,248.7133660-2
CPT CODE: $9,624.2033665-2
CPT CODE: $11,511.4733670-2
CPT CODE: $7,053.6433675-5
CPT CODE: $7,336.9833676-2
CPT CODE: $8,056.1033677-2
CPT CODE: $9,248.7133681-2
CPT CODE: $9,624.2033684-2
CPT CODE: $10,562.8933688-2
CPT CODE: $3,843.7433690-2
CPT CODE: $10,750.6433692-2
CPT CODE: $11,511.4733694-2
CPT CODE: $10,741.3433697-2
CPT CODE: $7,677.6233702-2
CPT CODE: $11,511.4733710-2
CPT CODE: $9,624.2033720-2
CPT CODE: $11,497.2233722-2
CPT CODE: $5,856.9033724-2
CPT CODE: $7,336.9833726-2
CPT CODE: $9,624.2033730-2
CPT CODE: $6,915.1433732-2
CPT CODE: $6,165.8433735-2
CPT CODE: $6,159.2033736-2
CPT CODE: $6,165.8433737-2
CPT CODE: $5,790.3333750-2
CPT CODE: $5,790.3333755-2
CPT CODE: $5,790.3333762-2
CPT CODE: $5,790.3333764-2
CPT CODE: $5,790.3333766-2
CPT CODE: $5,785.9233767-2
CPT CODE: $1,354.1233768-2
CPT CODE: $5,608.5933770-2
CPT CODE: $12,262.4233771-2
CPT CODE: $10,750.6433774-2
CPT CODE: $11,511.4733775-2
CPT CODE: $12,272.3433776-2
CPT CODE: $5,612.4333777-2
CPT CODE: $5,612.4333778-2
CPT CODE: $11,511.4733779-2
CPT CODE: $12,272.3433780-2
CPT CODE: $5,612.4333781-2
CPT CODE: $5,682.3033782-2
CPT CODE: $6,142.8533783-2
CPT CODE: $11,511.4733786-2
CPT CODE: $6,738.9033788-2
CPT CODE: $14,663.8533800-2
CPT CODE: $4,584.8633802-2
CPT CODE: $5,790.3333803-2
CPT CODE: $7,055.1333813-2
CPT CODE: $7,055.1333814-2
CPT CODE: $3,873.4033820-2
CPT CODE: $4,584.8633822-2
CPT CODE: $5,790.3333824-2
CPT CODE: $5,790.3333840-2
CPT CODE: $7,677.6233845-2
CPT CODE: $6,738.9033851-2
CPT CODE: $15,345.3533852-2
CPT CODE: $15,332.7233853-2
CPT CODE: $3,532.5333858-2
Page 17
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $2,535.4533859-2
CPT CODE: $10,741.3433863-2
CPT CODE: $7,862.3833864-2
CPT CODE: $1,074.9333866-2
CPT CODE: $3,395.1233871-2
CPT CODE: $9,564.9233875-2
CPT CODE: $9,564.9233877-2
CPT CODE: $8,428.5733910-2
CPT CODE: $5,790.3333915-2
CPT CODE: $14,535.1233916-2
CPT CODE: $8,426.9433917-2
CPT CODE: $9,612.1233920-2
CPT CODE: $14,520.8233922-2
CPT CODE: $5,010.1233924-2
CPT CODE: $6,991.0133925-2
CPT CODE: $8,225.2933926-2
CPT CODE: $13,191.2833945-2
CPT CODE: $385.8133946-2
CPT CODE: $422.3333947-2
CPT CODE: $298.7133948-2
CPT CODE: $291.1533949-2
CPT CODE: $495.4333951-2
CPT CODE: $483.6733952-2
CPT CODE: $552.3133953-2
CPT CODE: $539.3433954-2
CPT CODE: $1,086.1833955-2
CPT CODE: $1,029.0633956-2
CPT CODE: $321.2933957-2
CPT CODE: $313.5933958-2
CPT CODE: $380.1933959-2
CPT CODE: $361.9633962-2
CPT CODE: $657.4633963-2
CPT CODE: $668.1733964-2
CPT CODE: $317.6533965-2
CPT CODE: $359.6933966-2
CPT CODE: $1,115.4233967-2
CPT CODE: $904.1433968-2
CPT CODE: $396.4933969-2
CPT CODE: $2,312.1733970-2
CPT CODE: $2,035.5133971-2
CPT CODE: $2,314.3633973-2
CPT CODE: $2,034.4133974-2
CPT CODE: $389.2433984-2
CPT CODE: $737.9233985-2
CPT CODE: $703.6433986-2
CPT CODE: $292.0233987-2
CPT CODE: $921.6933988-2
CPT CODE: $604.9833989-2
CPT CODE: $513.0533990-2
CPT CODE: $747.8133991-2
CPT CODE: $244.4533992-2
CPT CODE: $214.6533993-2
CPT CODE: $3,201.4634001-2
CPT CODE: $4,406.9434051-2
CPT CODE: $2,964.3634101-2
CPT CODE: $2,964.3634111-2
CPT CODE: $5,227.0834151-2
CPT CODE: $2,588.8734201-2
CPT CODE: $2,499.9234203-2
CPT CODE: $6,353.5234401-2
CPT CODE: $2,519.6934421-2
CPT CODE: $2,154.1034451-2
CPT CODE: $6,353.5234471-2
CPT CODE: $2,391.2034490-2
CPT CODE: $4,841.7434501-2
CPT CODE: $9,434.8134502-2
CPT CODE: $5,227.0834510-2
CPT CODE: $5,227.0834520-2
CPT CODE: $2,608.6234530-2
CPT CODE: $1,815.1334701-2
CPT CODE: $2,336.6234702-2
CPT CODE: $2,266.9534703-2
CPT CODE: $2,002.8234704-2
CPT CODE: $1,894.9234705-2
CPT CODE: $2,413.9734706-2
CPT CODE: $1,205.4834707-2
CPT CODE: $1,942.4434708-2
CPT CODE: $338.8034709-2
CPT CODE: $924.9934710-2
CPT CODE: $312.6734711-2
CPT CODE: $720.4134712-2
CPT CODE: $135.4734713-2
CPT CODE: $284.9934714-2
CPT CODE: $319.3734715-2
CPT CODE: $395.4934716-2
CPT CODE: $465.1334717-2
CPT CODE: $1,294.4534718-2
CPT CODE: $424.2534808-2
CPT CODE: $639.4934812-2
CPT CODE: $592.7034813-2
CPT CODE: $976.3834820-2
CPT CODE: $941.2834833-2
CPT CODE: $473.6634834-2
CPT CODE: $5,039.3335001-2
CPT CODE: $5,039.3335002-2
CPT CODE: $5,039.3335005-2
CPT CODE: $3,843.7435011-2
CPT CODE: $3,911.6035013-2
CPT CODE: $6,353.5235021-2
CPT CODE: $6,353.5235022-2
CPT CODE: $3,843.7435045-2
CPT CODE: $7,134.1535081-2
CPT CODE: $7,578.8135082-2
CPT CODE: $7,677.6235091-2
CPT CODE: $7,677.6235092-2
CPT CODE: $7,134.1535102-2
CPT CODE: $7,134.1535103-2
CPT CODE: $5,355.5735111-2
CPT CODE: $5,355.5735112-2
CPT CODE: $7,677.6235121-2
CPT CODE: $7,677.6235122-2
CPT CODE: $6,353.5235131-2
CPT CODE: $6,353.5235132-2
CPT CODE: $4,841.7435141-2
CPT CODE: $4,841.7435142-2
CPT CODE: $5,227.0835151-2
CPT CODE: $5,227.0835152-2
CPT CODE: $5,227.0835180-2
CPT CODE: $7,865.3635182-2
CPT CODE: $5,227.0835184-2
CPT CODE: $5,227.0835188-2
CPT CODE: $7,865.3635189-2
CPT CODE: $5,227.0835190-2
CPT CODE: $5,227.0835201-2
CPT CODE: $5,227.0835206-2
CPT CODE: $2,638.2635207-2
CPT CODE: $7,865.3635211-2
CPT CODE: $7,865.3635216-2
CPT CODE: $7,865.3635221-2
CPT CODE: $5,409.9235226-2
CPT CODE: $6,521.5235231-2
CPT CODE: $6,521.5235236-2
CPT CODE: $9,821.8335241-2
CPT CODE: $9,821.8335246-2
CPT CODE: $9,821.8335251-2
CPT CODE: $5,227.0835256-2
CPT CODE: $5,227.0835261-2
CPT CODE: $5,227.0835266-2
CPT CODE: $7,865.3635271-2
CPT CODE: $7,865.3635276-2
CPT CODE: $7,114.3635281-2
CPT CODE: $5,227.0835286-2
CPT CODE: $4,782.4635301-2
CPT CODE: $3,977.4535302-2
CPT CODE: $4,197.3835303-2
CPT CODE: $4,418.6435304-2
CPT CODE: $4,197.3835305-2
CPT CODE: $839.2135306-2
CPT CODE: $5,790.3335311-2
CPT CODE: $6,096.6535321-2
CPT CODE: $6,353.5235331-2
CPT CODE: $7,677.6235341-2
Page 18
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $6,165.8435351-2
CPT CODE: $6,748.7835355-2
CPT CODE: $7,114.3635361-2
CPT CODE: $7,045.2135363-2
CPT CODE: $4,406.9435371-2
CPT CODE: $4,406.9435372-2
CPT CODE: $4,778.0535390-2
CPT CODE: $6,165.8435501-2
CPT CODE: $6,165.8435506-2
CPT CODE: $6,096.6535508-2
CPT CODE: $6,096.6535509-2
CPT CODE: $5,089.4035510-2
CPT CODE: $5,227.0835511-2
CPT CODE: $4,363.4035512-2
CPT CODE: $6,096.6535515-2
CPT CODE: $5,227.0835516-2
CPT CODE: $5,227.0835518-2
CPT CODE: $4,406.9435521-2
CPT CODE: $3,668.3935522-2
CPT CODE: $3,156.3335523-2
CPT CODE: $3,557.7235525-2
CPT CODE: $6,353.5235526-2
CPT CODE: $6,205.3235531-2
CPT CODE: $6,096.6535533-2
CPT CODE: $4,639.9835535-2
CPT CODE: $6,353.5235536-2
CPT CODE: $4,840.9535537-2
CPT CODE: $4,840.9535538-2
CPT CODE: $4,840.9535539-2
CPT CODE: $4,840.9535540-2
CPT CODE: $5,731.0335556-2
CPT CODE: $5,227.0835558-2
CPT CODE: $6,887.1135560-2
CPT CODE: $6,096.6535563-2
CPT CODE: $6,096.6535565-2
CPT CODE: $6,165.8435566-2
CPT CODE: $4,460.2235570-2
CPT CODE: $6,096.6535571-2
CPT CODE: $6,165.8435583-2
CPT CODE: $6,165.8435585-2
CPT CODE: $3,320.0735587-2
CPT CODE: $5,414.8535601-2
CPT CODE: $5,414.8535606-2
CPT CODE: $4,406.9435612-2
CPT CODE: $4,406.9435616-2
CPT CODE: $5,839.7335621-2
CPT CODE: $4,843.4235623-2
CPT CODE: $6,353.5235626-2
CPT CODE: $7,114.3635631-2
CPT CODE: $5,202.5235632-2
CPT CODE: $5,202.5235633-2
CPT CODE: $5,202.5235634-2
CPT CODE: $6,353.5235636-2
CPT CODE: $4,840.9535637-2
CPT CODE: $4,840.9535638-2
CPT CODE: $5,414.8535642-2
CPT CODE: $5,414.8535645-2
CPT CODE: $6,373.3135646-2
CPT CODE: $4,995.4235647-2
CPT CODE: $4,318.0335650-2
CPT CODE: $6,096.6535654-2
CPT CODE: $4,387.2035656-2
CPT CODE: $4,406.9435661-2
CPT CODE: $4,406.9435663-2
CPT CODE: $4,406.9435665-2
CPT CODE: $4,841.7435666-2
CPT CODE: $4,841.7435671-2
CPT CODE: $3,201.4635681-2
CPT CODE: $925.6535685-2
CPT CODE: $1,049.0735686-2
CPT CODE: $5,403.3235691-2
CPT CODE: $5,403.3235693-2
CPT CODE: $5,403.3235694-2
CPT CODE: $5,403.3235695-2
CPT CODE: $593.2035697-2
CPT CODE: $1,936.7035701-2
CPT CODE: $426.0035702-2
CPT CODE: $432.5735703-2
CPT CODE: $1,936.7035800-2
CPT CODE: $2,539.4335820-2
CPT CODE: $2,509.7935840-2
CPT CODE: $1,630.3735860-2
CPT CODE: $2,203.4835870-2
CPT CODE: $2,588.8735875-2
CPT CODE: $2,585.0235876-2
CPT CODE: $2,363.0735879-2
CPT CODE: $2,363.0735881-2
CPT CODE: $2,454.2135883-2
CPT CODE: $2,680.8735884-2
CPT CODE: $2,202.4035901-2
CPT CODE: $2,202.4035903-2
CPT CODE: $2,202.4035905-2
CPT CODE: $2,202.4035907-2
CPT CODE: $102.7636000-2
CPT CODE: $435.0636002-2
CPT CODE: $237.2336005-2
CPT CODE: $407.4636010-2
CPT CODE: $522.2836011-2
CPT CODE: $503.9536012-2
CPT CODE: $407.4636013-2
CPT CODE: $522.2836014-2
CPT CODE: $625.9936015-2
CPT CODE: $444.6536100-2
CPT CODE: $161.1236140-2
CPT CODE: $306.3036160-2
CPT CODE: $335.9536200-2
CPT CODE: $522.2836215-2
CPT CODE: $503.9536216-2
CPT CODE: $625.9936217-2
CPT CODE: $112.6436218-2
CPT CODE: $255.7636221-2
CPT CODE: $347.7736222-2
CPT CODE: $376.0736223-2
CPT CODE: $410.6436224-2
CPT CODE: $374.6836225-2
CPT CODE: $411.4236226-2
CPT CODE: $130.3936227-2
CPT CODE: $266.0436228-2
CPT CODE: $522.2836245-2
CPT CODE: $503.9536246-2
CPT CODE: $625.9936247-2
CPT CODE: $112.6436248-2
CPT CODE: $1,723.1336251-2
CPT CODE: $1,892.7036252-2
CPT CODE: $2,635.5136253-2
CPT CODE: $2,742.3436254-2
CPT CODE: $6,274.5036260-2
CPT CODE: $3,132.2836261-2
CPT CODE: $3,102.6736262-2
CPT CODE: $104.7336400-2
CPT CODE: $128.4436405-2
CPT CODE: $102.7636406-2
CPT CODE: $73.1036410-2
CPT CODE: $7.1236415-2
CPT CODE: $4.5136416-2
CPT CODE: $207.4836420-2
CPT CODE: $128.4436425-2
CPT CODE: $61.2636430-2
CPT CODE: $316.2136440-2
CPT CODE: $1,274.6736450-2
CPT CODE: $1,274.6736455-2
CPT CODE: $118.7536456-2
CPT CODE: $316.2136460-2
CPT CODE: $125.3336465-2
CPT CODE: $159.5936466-2
CPT CODE: $187.7336468-2
CPT CODE: $126.4936470-2
CPT CODE: $187.7336471-2
CPT CODE: $1,888.2136475-2
CPT CODE: $944.1136476-2
CPT CODE: $1,691.9536478-2
CPT CODE: $846.7036479-2
Page 19
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $711.4436481-2
CPT CODE: $711.4436500-2
CPT CODE: $187.7336510-2
CPT CODE: $431.5536511-2
CPT CODE: $431.5536512-2
CPT CODE: $431.5536513-2
CPT CODE: $431.5536514-2
CPT CODE: $538.3036516-2
CPT CODE: $503.9536522-2
CPT CODE: $202.1636555-2
CPT CODE: $191.8336556-2
CPT CODE: $700.9236557-2
CPT CODE: $665.5036558-2
CPT CODE: $838.1436560-2
CPT CODE: $804.2136561-2
CPT CODE: $4,871.0136563-2
CPT CODE: $804.2136565-2
CPT CODE: $864.7136566-2
CPT CODE: $147.5636568-2
CPT CODE: $140.1936569-2
CPT CODE: $726.0036570-2
CPT CODE: $689.1136571-2
CPT CODE: $98.8836572-2
CPT CODE: $91.0036573-2
CPT CODE: $138.7036575-2
CPT CODE: $523.8536576-2
CPT CODE: $588.7736578-2
CPT CODE: $104.7736580-2
CPT CODE: $556.3136581-2
CPT CODE: $810.1236582-2
CPT CODE: $817.4936583-2
CPT CODE: $103.2936584-2
CPT CODE: $759.9436585-2
CPT CODE: $776.1736589-2
CPT CODE: $2,434.7736590-2
CPT CODE: $11.6436591-2
CPT CODE: $11.6436592-2
CPT CODE: $41.3936593-2
CPT CODE: $290.7036595-2
CPT CODE: $264.1436596-2
CPT CODE: $95.9236597-2
CPT CODE: $157.0436598-2
CPT CODE: $120.5336600-2
CPT CODE: $272.7436620-2
CPT CODE: $365.5836625-2
CPT CODE: $375.4636640-2
CPT CODE: $306.3036660-2
CPT CODE: $523.7036680-2
CPT CODE: $1,363.6036810-2
CPT CODE: $820.1336815-2
CPT CODE: $1,868.1636818-2
CPT CODE: $2,196.4636819-2
CPT CODE: $1,126.2136820-2
CPT CODE: $2,401.0936821-2
CPT CODE: $739.2136823-2
CPT CODE: $3,843.7436825-2
CPT CODE: $3,231.1036830-2
CPT CODE: $2,247.4836831-2
CPT CODE: $4,110.5336832-2
CPT CODE: $2,247.4836833-2
CPT CODE: $3,206.5236838-2
CPT CODE: $251.0036860-2
CPT CODE: $316.2136861-2
CPT CODE: $120.6136901-2
CPT CODE: $239.4036902-2
CPT CODE: $327.8036903-2
CPT CODE: $377.3636904-2
CPT CODE: $473.5936905-2
CPT CODE: $552.5936906-2
CPT CODE: $137.9236907-2
CPT CODE: $206.6836908-2
CPT CODE: $196.1936909-2
CPT CODE: $6,343.6337140-2
CPT CODE: $6,353.5237145-2
CPT CODE: $6,353.5237160-2
CPT CODE: $6,353.5237180-2
CPT CODE: $6,353.5237181-2
CPT CODE: $1,013.8637187-2
CPT CODE: $727.3437188-2
CPT CODE: $3,129.9337191-2
CPT CODE: $2,107.0737192-2
CPT CODE: $2,011.2637193-2
CPT CODE: $374.3337197-2
CPT CODE: $245.0637200-2
CPT CODE: $767.8737211-2
CPT CODE: $677.8837212-2
CPT CODE: $474.0237213-2
CPT CODE: $277.3337214-2
CPT CODE: $1,290.3437217-2
CPT CODE: $972.3437218-2
CPT CODE: $878.4037220-2
CPT CODE: $2,019.0637221-2
CPT CODE: $398.5337222-2
CPT CODE: $854.6237223-2
CPT CODE: $836.6937224-2
CPT CODE: $1,715.1037225-2
CPT CODE: $1,998.2137226-2
CPT CODE: $2,646.5837227-2
CPT CODE: $1,046.5037228-2
CPT CODE: $2,027.2837229-2
CPT CODE: $2,103.1137230-2
CPT CODE: $2,855.1237231-2
CPT CODE: $318.4637232-2
CPT CODE: $522.4537233-2
CPT CODE: $437.9437234-2
CPT CODE: $621.2537235-2
CPT CODE: $611.6437236-2
CPT CODE: $285.3037237-2
CPT CODE: $428.5137238-2
CPT CODE: $199.1337239-2
CPT CODE: $598.7737241-2
CPT CODE: $668.4637242-2
CPT CODE: $796.9637243-2
CPT CODE: $929.7837244-2
CPT CODE: $392.3837246-2
CPT CODE: $194.5437247-2
CPT CODE: $337.4137248-2
CPT CODE: $165.5237249-2
CPT CODE: $103.5037252-2
CPT CODE: $82.6837253-2
CPT CODE: $323.2937500-2
CPT CODE: $2,272.6737565-2
CPT CODE: $1,630.3737600-2
CPT CODE: $2,272.6737605-2
CPT CODE: $2,826.0237606-2
CPT CODE: $811.9137607-2
CPT CODE: $582.9837609-2
CPT CODE: $2,272.6737615-2
CPT CODE: $2,272.6737616-2
CPT CODE: $2,272.6737617-2
CPT CODE: $2,203.4837618-2
CPT CODE: $1,946.6437619-2
CPT CODE: $1,254.9137650-2
CPT CODE: $2,203.4837660-2
CPT CODE: $1,126.4637700-2
CPT CODE: $1,425.7637718-2
CPT CODE: $1,715.0437722-2
CPT CODE: $2,964.3637735-2
CPT CODE: $2,203.4837760-2
CPT CODE: $991.8637761-2
CPT CODE: $731.9137765-2
CPT CODE: $938.4937766-2
CPT CODE: $760.8337780-2
CPT CODE: $316.2137785-2
CPT CODE: $4,841.7437788-2
CPT CODE: $839.9137790-2
CPT CODE: $3,567.0938100-2
CPT CODE: $3,646.1038101-2
CPT CODE: $1,782.4538102-2
CPT CODE: $3,646.1038115-2
CPT CODE: $2,442.3238120-2
CPT CODE: $405.1138200-2
Page 20
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $61.5438220-2
CPT CODE: $105.3738221-2
CPT CODE: $84.2338222-2
CPT CODE: $879.4138230-2
CPT CODE: $523.4538232-2
CPT CODE: $879.4138240-2
CPT CODE: $879.4138241-2
CPT CODE: $52.6338242-2
CPT CODE: $141.7438243-2
CPT CODE: $199.5938300-2
CPT CODE: $1,205.4638305-2
CPT CODE: $1,195.5938308-2
CPT CODE: $2,272.6738380-2
CPT CODE: $2,272.6738381-2
CPT CODE: $2,272.6738382-2
CPT CODE: $899.1638500-2
CPT CODE: $563.1938505-2
CPT CODE: $899.1638510-2
CPT CODE: $800.3838520-2
CPT CODE: $642.2738525-2
CPT CODE: $1,758.8438530-2
CPT CODE: $453.9638531-2
CPT CODE: $879.4138542-2
CPT CODE: $1,571.0938550-2
CPT CODE: $1,531.5538555-2
CPT CODE: $1,887.2938562-2
CPT CODE: $3,527.5338564-2
CPT CODE: $1,509.0738570-2
CPT CODE: $2,519.9638571-2
CPT CODE: $3,031.0738572-2
CPT CODE: $2,106.2238573-2
CPT CODE: $2,717.3038700-2
CPT CODE: $3,774.5838720-2
CPT CODE: $3,774.5838724-2
CPT CODE: $1,679.7738740-2
CPT CODE: $3,260.7838745-2
CPT CODE: $839.9138746-2
CPT CODE: $1,297.1738747-2
CPT CODE: $2,588.8738760-2
CPT CODE: $3,814.1038770-2
CPT CODE: $7,114.3638780-2
CPT CODE: $622.5038790-2
CPT CODE: $465.1238792-2
CPT CODE: $523.7038794-2
CPT CODE: $239.0038900-2
CPT CODE: $2,588.8739000-2
CPT CODE: $3,893.1839010-2
CPT CODE: $5,088.7839200-2
CPT CODE: $5,078.9039220-2
CPT CODE: $346.2839401-2
CPT CODE: $452.0439402-2
CPT CODE: $4,841.7439503-2
CPT CODE: $4,406.9439540-2
CPT CODE: $4,011.7339541-2
CPT CODE: $4,841.7439545-2
CPT CODE: $3,147.5239560-2
CPT CODE: $3,933.5839561-2
CPT CODE: $375.4640490-2
CPT CODE: $1,235.1240500-2
CPT CODE: $1,235.1240510-2
CPT CODE: $899.1640520-2
CPT CODE: $2,796.3440525-2
CPT CODE: $2,816.0940527-2
CPT CODE: $1,571.0940530-2
CPT CODE: $849.7740650-2
CPT CODE: $1,571.0940652-2
CPT CODE: $3,142.1940654-2
CPT CODE: $2,282.5040700-2
CPT CODE: $3,339.8240701-2
CPT CODE: $4,100.6540702-2
CPT CODE: $2,519.6940720-2
CPT CODE: $3,616.4640761-2
CPT CODE: $124.5040800-2
CPT CODE: $345.8440801-2
CPT CODE: $181.8140804-2
CPT CODE: $563.1940805-2
CPT CODE: $124.5040806-2
CPT CODE: $185.7740808-2
CPT CODE: $185.7740810-2
CPT CODE: $365.5840812-2
CPT CODE: $820.1340814-2
CPT CODE: $879.4140816-2
CPT CODE: $395.2640818-2
CPT CODE: $316.2140819-2
CPT CODE: $306.3040820-2
CPT CODE: $249.0140830-2
CPT CODE: $395.2640831-2
CPT CODE: $1,324.0740840-2
CPT CODE: $879.4140842-2
CPT CODE: $1,699.5640843-2
CPT CODE: $2,045.4040844-2
CPT CODE: $3,102.6740845-2
CPT CODE: $235.1541000-2
CPT CODE: $691.6941005-2
CPT CODE: $513.8341006-2
CPT CODE: $691.6941007-2
CPT CODE: $444.6541008-2
CPT CODE: $1,077.0341009-2
CPT CODE: $233.1941010-2
CPT CODE: $1,017.7541015-2
CPT CODE: $1,017.7541016-2
CPT CODE: $1,017.7541017-2
CPT CODE: $1,571.0941018-2
CPT CODE: $264.7941100-2
CPT CODE: $523.7041105-2
CPT CODE: $345.8441108-2
CPT CODE: $280.6341110-2
CPT CODE: $760.8341112-2
CPT CODE: $1,017.7541113-2
CPT CODE: $938.6841114-2
CPT CODE: $464.3841115-2
CPT CODE: $770.7341116-2
CPT CODE: $1,274.6741120-2
CPT CODE: $2,460.3941130-2
CPT CODE: $4,841.7441135-2
CPT CODE: $4,011.7341140-2
CPT CODE: $5,721.1541145-2
CPT CODE: $6,096.6541150-2
CPT CODE: $5,464.2241153-2
CPT CODE: $6,096.6541155-2
CPT CODE: $249.0141250-2
CPT CODE: $365.5841251-2
CPT CODE: $563.1941252-2
CPT CODE: $2,203.4841510-2
CPT CODE: $494.0541520-2
CPT CODE: $258.8941800-I
CPT CODE: $1,037.5041826-I
CPT CODE: $296.4342000-2
CPT CODE: $316.2142100-2
CPT CODE: $268.7742104-2
CPT CODE: $602.7542106-2
CPT CODE: $938.6842107-2
CPT CODE: $1,531.5542120-2
CPT CODE: $306.3042140-2
CPT CODE: $3,527.5342145-2
CPT CODE: $444.6542160-2
CPT CODE: $444.6542180-2
CPT CODE: $2,134.3242182-2
CPT CODE: $3,438.6442200-2
CPT CODE: $4,327.9342205-2
CPT CODE: $4,841.7442210-2
CPT CODE: $2,865.5342215-2
CPT CODE: $3,646.1042220-2
CPT CODE: $3,646.1042225-2
CPT CODE: $3,646.1042226-2
CPT CODE: $3,646.1042227-2
CPT CODE: $3,468.2742235-2
CPT CODE: $2,282.5042260-2
CPT CODE: $233.1942300-2
CPT CODE: $513.8342305-2
CPT CODE: $251.0042310-2
CPT CODE: $691.6942320-2
Page 21
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $375.4642330-2
CPT CODE: $1,017.7542335-2
CPT CODE: $1,254.9142340-2
CPT CODE: $563.1942400-2
CPT CODE: $553.3342405-2
CPT CODE: $889.2842408-2
CPT CODE: $770.7342409-2
CPT CODE: $1,333.9442410-2
CPT CODE: $3,161.9742415-2
CPT CODE: $3,853.6742420-2
CPT CODE: $2,826.0242425-2
CPT CODE: $5,187.5642426-2
CPT CODE: $1,620.4942440-2
CPT CODE: $1,195.5942450-2
CPT CODE: $1,571.0942500-2
CPT CODE: $1,363.6042505-2
CPT CODE: $1,571.0942507-2
CPT CODE: $2,391.2042509-2
CPT CODE: $2,391.2042510-2
CPT CODE: $124.5042550-2
CPT CODE: $1,571.0942600-2
CPT CODE: $154.1542650-2
CPT CODE: $245.0642660-2
CPT CODE: $187.7342665-2
CPT CODE: $306.3042700-2
CPT CODE: $523.7042720-2
CPT CODE: $1,274.6742725-2
CPT CODE: $185.7742800-2
CPT CODE: $249.0142804-2
CPT CODE: $405.1142806-2
CPT CODE: $780.6042808-2
CPT CODE: $780.6042809-2
CPT CODE: $1,077.0342810-2
CPT CODE: $2,302.3142815-2
CPT CODE: $1,106.7142820-2
CPT CODE: $1,106.7142821-2
CPT CODE: $1,037.5042825-2
CPT CODE: $1,037.5042826-2
CPT CODE: $681.8142830-2
CPT CODE: $563.1942831-2
CPT CODE: $474.2742835-2
CPT CODE: $563.1942836-2
CPT CODE: $1,511.8142842-2
CPT CODE: $2,648.1442844-2
CPT CODE: $2,648.1442845-2
CPT CODE: $405.1142860-2
CPT CODE: $444.6542870-2
CPT CODE: $4,140.1742890-2
CPT CODE: $5,098.6642892-2
CPT CODE: $4,851.6142894-2
CPT CODE: $2,519.6942900-2
CPT CODE: $3,142.1942950-2
CPT CODE: $4,268.6642953-2
CPT CODE: $3,142.1942955-2
CPT CODE: $335.9542960-2
CPT CODE: $365.5842961-2
CPT CODE: $444.6542962-2
CPT CODE: $444.6542970-2
CPT CODE: $444.6542972-2
CPT CODE: $2,885.2743020-2
CPT CODE: $2,964.3643030-2
CPT CODE: $3,468.2743100-2
CPT CODE: $4,525.5543101-2
CPT CODE: $5,673.7443107-2
CPT CODE: $6,617.8643108-2
CPT CODE: $6,617.8643112-2
CPT CODE: $6,617.8643113-2
CPT CODE: $6,617.8643116-2
CPT CODE: $6,617.8643117-2
CPT CODE: $6,617.8643118-2
CPT CODE: $5,846.2143121-2
CPT CODE: $5,846.2143122-2
CPT CODE: $6,617.8643123-2
CPT CODE: $5,673.7443124-2
CPT CODE: $3,774.5843130-2
CPT CODE: $4,525.5543135-2
CPT CODE: $562.4043180-2
CPT CODE: $636.4143180-4
CPT CODE: $147.1443191-2
CPT CODE: $175.5743192-2
CPT CODE: $209.3343193-2
CPT CODE: $190.6343194-2
CPT CODE: $209.7243195-2
CPT CODE: $228.9843196-2
CPT CODE: $94.0143197-2
CPT CODE: $111.9943198-2
CPT CODE: $652.1943200-2
CPT CODE: $22.5643201-2
CPT CODE: $810.2643202-2
CPT CODE: $1,254.9143204-2
CPT CODE: $1,511.8143205-2
CPT CODE: $483.4143210-2
CPT CODE: $284.3443211-2
CPT CODE: $223.0943212-2
CPT CODE: $315.8343213-2
CPT CODE: $228.4243214-2
CPT CODE: $1,225.2443215-2
CPT CODE: $1,511.8143216-2
CPT CODE: $1,511.8143217-2
CPT CODE: $830.0243220-2
CPT CODE: $602.7543226-2
CPT CODE: $1,511.8143227-2
CPT CODE: $240.6643229-2
CPT CODE: $818.8643231-2
CPT CODE: $859.4143232-2
CPT CODE: $271.2043233-2
CPT CODE: $741.0843235-2
CPT CODE: $932.2743236-2
CPT CODE: $798.3143237-2
CPT CODE: $937.0243238-2
CPT CODE: $830.0243239-2
CPT CODE: $1,469.2643240-2
CPT CODE: $1,511.8143241-2
CPT CODE: $1,402.2043242-2
CPT CODE: $1,482.1543243-2
CPT CODE: $1,483.8243244-2
CPT CODE: $978.2343245-2
CPT CODE: $1,511.8143246-2
CPT CODE: $889.2843247-2
CPT CODE: $951.8843248-2
CPT CODE: $953.2043249-2
CPT CODE: $1,278.5043250-2
CPT CODE: $1,274.6743251-2
CPT CODE: $314.5843253-2
CPT CODE: $326.3943254-2
CPT CODE: $1,175.8643255-2
CPT CODE: $1,511.8143259-2
CPT CODE: $1,245.0243260-2
CPT CODE: $1,250.5043261-2
CPT CODE: $1,887.2943262-2
CPT CODE: $2,203.4843263-2
CPT CODE: $2,638.2643264-2
CPT CODE: $3,478.1643265-2
CPT CODE: $269.9743266-2
CPT CODE: $283.8943270-2
CPT CODE: $264.9743273-2
CPT CODE: $916.1543274-2
CPT CODE: $755.2043275-2
CPT CODE: $953.3443276-2
CPT CODE: $759.9343277-2
CPT CODE: $684.1943278-2
CPT CODE: $2,929.0843279-2
CPT CODE: $2,911.3943280-2
CPT CODE: $2,673.2643281-2
CPT CODE: $3,007.7443282-2
CPT CODE: $286.4643283-2
CPT CODE: $5,039.3343300-2
CPT CODE: $4,327.9343305-2
CPT CODE: $5,414.8543310-2
CPT CODE: $5,721.1543312-2
CPT CODE: $5,185.2043313-2
CPT CODE: $5,479.8443314-2
Page 22
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $4,841.7443320-2
CPT CODE: $3,843.7443325-2
CPT CODE: $2,363.4843327-2
CPT CODE: $2,376.1143328-2
CPT CODE: $4,011.7343330-2
CPT CODE: $3,774.5843331-2
CPT CODE: $2,687.0343332-2
CPT CODE: $2,699.6843333-2
CPT CODE: $2,660.5043334-2
CPT CODE: $2,673.1343335-2
CPT CODE: $2,660.7643336-2
CPT CODE: $2,906.2243337-2
CPT CODE: $236.4843338-2
CPT CODE: $4,406.9443340-2
CPT CODE: $4,406.9443341-2
CPT CODE: $2,519.6943351-2
CPT CODE: $2,519.6943352-2
CPT CODE: $5,846.2143360-2
CPT CODE: $6,617.8643361-2
CPT CODE: $4,841.7443400-2
CPT CODE: $3,776.4243405-2
CPT CODE: $3,774.5843410-2
CPT CODE: $4,525.5543415-2
CPT CODE: $2,519.6943420-2
CPT CODE: $4,100.6543425-2
CPT CODE: $233.1943450-2
CPT CODE: $632.3943453-2
CPT CODE: $1,017.7543460-2
CPT CODE: $8,046.3343496-2
CPT CODE: $2,519.6943500-2
CPT CODE: $2,786.4643501-2
CPT CODE: $2,786.9643502-2
CPT CODE: $2,786.4643510-2
CPT CODE: $2,341.8343520-2
CPT CODE: $2,519.6943605-2
CPT CODE: $2,322.0543610-2
CPT CODE: $2,323.7043611-2
CPT CODE: $5,464.2243620-2
CPT CODE: $5,459.3243621-2
CPT CODE: $6,653.8343622-2
CPT CODE: $4,526.1043631-2
CPT CODE: $4,526.1043632-2
CPT CODE: $4,526.1043633-2
CPT CODE: $6,653.8343634-2
CPT CODE: $1,253.8543635-2
CPT CODE: $3,814.1043640-2
CPT CODE: $2,786.4643641-2
CPT CODE: $2,535.7743644-2
CPT CODE: $2,763.5643645-2
CPT CODE: $1,275.0043647-2
CPT CODE: $1,338.4143648-2
CPT CODE: $1,714.4843651-2
CPT CODE: $2,361.4443652-2
CPT CODE: $1,585.0843653-2
CPT CODE: $51.4843752-2
CPT CODE: $97.9543753-2
CPT CODE: $145.3543754-2
CPT CODE: $264.0343755-2
CPT CODE: $364.3543756-2
CPT CODE: $469.4343757-2
CPT CODE: $187.7343761-2
CPT CODE: $39.9943762-2
CPT CODE: $88.0043763-2
CPT CODE: $2,329.4243770-2
CPT CODE: $2,388.6543771-2
CPT CODE: $1,613.1143772-2
CPT CODE: $2,388.6543773-2
CPT CODE: $1,613.1143774-2
CPT CODE: $2,175.4143775-2
CPT CODE: $2,717.3043800-2
CPT CODE: $3,142.1943810-2
CPT CODE: $3,142.1943820-2
CPT CODE: $3,685.6543825-2
CPT CODE: $2,262.7843830-2
CPT CODE: $1,660.0443831-2
CPT CODE: $3,329.9443832-2
CPT CODE: $2,717.3043840-2
CPT CODE: $4,840.1343843-2
CPT CODE: $2,763.5643845-2
CPT CODE: $5,078.9043846-2
CPT CODE: $4,103.2443847-2
CPT CODE: $4,103.2443848-2
CPT CODE: $4,525.5543850-2
CPT CODE: $4,901.0443855-2
CPT CODE: $3,922.8043860-2
CPT CODE: $4,901.0443865-2
CPT CODE: $2,519.6943880-2
CPT CODE: $1,275.0043881-2
CPT CODE: $1,338.4143882-2
CPT CODE: $505.5743886-2
CPT CODE: $495.9143887-2
CPT CODE: $706.6943888-2
CPT CODE: $2,835.8844005-2
CPT CODE: $3,468.2744010-2
CPT CODE: $691.6944015-2
CPT CODE: $3,270.6644020-2
CPT CODE: $2,539.4344021-2
CPT CODE: $3,389.2144025-2
CPT CODE: $2,470.2544050-2
CPT CODE: $2,420.8744055-2
CPT CODE: $335.9544100-2
CPT CODE: $2,697.5044110-2
CPT CODE: $4,100.6544111-2
CPT CODE: $3,636.2444120-2
CPT CODE: $907.7944121-2
CPT CODE: $3,636.2444125-2
CPT CODE: $3,488.1744126-2
CPT CODE: $3,963.3444127-2
CPT CODE: $791.4344128-2
CPT CODE: $2,638.2644130-2
CPT CODE: $1,161.9744139-2
CPT CODE: $3,478.1644140-2
CPT CODE: $4,140.1744141-2
CPT CODE: $3,893.1844143-2
CPT CODE: $3,626.3444144-2
CPT CODE: $3,695.5344145-2
CPT CODE: $5,069.0144146-2
CPT CODE: $5,069.0144147-2
CPT CODE: $5,069.0144150-2
CPT CODE: $4,229.1244151-2
CPT CODE: $6,699.3844155-2
CPT CODE: $8,665.7044156-2
CPT CODE: $4,324.2044157-2
CPT CODE: $5,550.6244158-2
CPT CODE: $3,448.4944160-2
CPT CODE: $1,115.8144180-2
CPT CODE: $1,473.9744186-2
CPT CODE: $1,877.5944187-2
CPT CODE: $2,012.5944188-2
CPT CODE: $3,323.8344202-2
CPT CODE: $791.4344203-2
CPT CODE: $2,599.5444204-2
CPT CODE: $3,005.2844205-2
CPT CODE: $3,314.0644206-6
CPT CODE: $3,136.6244207-2
CPT CODE: $4,300.4644208-2
CPT CODE: $4,300.4644210-2
CPT CODE: $3,898.9844211-2
CPT CODE: $5,694.3544212-2
CPT CODE: $903.6744213-2
CPT CODE: $2,909.3644227-2
CPT CODE: $2,173.8444300-2
CPT CODE: $2,410.9944310-2
CPT CODE: $1,739.0944312-2
CPT CODE: $2,578.9544314-2
CPT CODE: $2,588.8744316-2
CPT CODE: $2,588.8744320-2
CPT CODE: $3,310.1644322-2
CPT CODE: $316.2144340-2
CPT CODE: $1,571.0944345-2
CPT CODE: $4,011.7344346-2
CPT CODE: $1,383.3344360-2
Page 23
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $1,511.8144361-2
CPT CODE: $1,511.8144363-2
CPT CODE: $1,511.8144364-2
CPT CODE: $1,511.8144365-2
CPT CODE: $1,511.8144366-2
CPT CODE: $1,511.8144369-2
CPT CODE: $1,335.1244370-2
CPT CODE: $2,055.2644372-2
CPT CODE: $2,055.2644373-2
CPT CODE: $1,381.1444376-2
CPT CODE: $1,511.8144377-2
CPT CODE: $1,511.8144378-2
CPT CODE: $1,335.1244379-2
CPT CODE: $316.2144380-2
CPT CODE: $395.2644382-2
CPT CODE: $240.1444384-2
CPT CODE: $271.7444384-4
CPT CODE: $316.2144385-2
CPT CODE: $395.2644386-2
CPT CODE: $316.2144388-2
CPT CODE: $395.2644389-2
CPT CODE: $395.2644390-2
CPT CODE: $395.2644391-2
CPT CODE: $395.2644392-2
CPT CODE: $391.9644394-2
CPT CODE: $521.4444401-2
CPT CODE: $590.0544401-4
CPT CODE: $374.5844402-2
CPT CODE: $423.8744402-4
CPT CODE: $115.7244500-2
CPT CODE: $2,566.3644602-2
CPT CODE: $3,387.6044603-2
CPT CODE: $2,697.0244604-2
CPT CODE: $3,389.2144605-2
CPT CODE: $2,566.3644615-2
CPT CODE: $2,371.4444620-2
CPT CODE: $3,735.0844625-2
CPT CODE: $3,567.8944626-2
CPT CODE: $2,401.0944640-2
CPT CODE: $3,142.1944650-2
CPT CODE: $3,142.1944660-2
CPT CODE: $3,438.6444661-2
CPT CODE: $4,525.5544680-2
CPT CODE: $3,003.6444700-2
CPT CODE: $285.6944701-2
CPT CODE: $2,519.6944800-2
CPT CODE: $2,272.6744820-2
CPT CODE: $2,272.6744850-2
CPT CODE: $1,383.3344900-2
CPT CODE: $1,600.7444950-2
CPT CODE: $1,936.7044960-2
CPT CODE: $1,467.0244970-2
CPT CODE: $622.5045000-2
CPT CODE: $395.2645005-2
CPT CODE: $1,017.7545020-2
CPT CODE: $691.6945100-2
CPT CODE: $2,519.6945108-2
CPT CODE: $5,632.2245110-2
CPT CODE: $2,826.0245111-2
CPT CODE: $5,414.8545112-2
CPT CODE: $5,410.4545113-2
CPT CODE: $4,327.9345114-2
CPT CODE: $8,277.7645119-2
CPT CODE: $6,096.6545120-2
CPT CODE: $6,699.3845121-2
CPT CODE: $2,832.3245123-2
CPT CODE: $8,861.9945126-2
CPT CODE: $3,270.6645130-2
CPT CODE: $5,721.1545135-2
CPT CODE: $4,981.5545136-2
CPT CODE: $1,126.4645150-2
CPT CODE: $2,519.6945160-2
CPT CODE: $1,002.1545171-2
CPT CODE: $1,456.2745172-2
CPT CODE: $1,624.9545190-2
CPT CODE: $118.5945300-2
CPT CODE: $185.7745303-2
CPT CODE: $245.0645305-2
CPT CODE: $513.8345307-2
CPT CODE: $272.5045308-2
CPT CODE: $272.5045309-2
CPT CODE: $444.6545315-2
CPT CODE: $375.4645317-2
CPT CODE: $523.7045320-2
CPT CODE: $444.6545321-2
CPT CODE: $358.7445327-2
CPT CODE: $193.6645330-2
CPT CODE: $262.8045331-2
CPT CODE: $187.7345332-2
CPT CODE: $375.4645333-2
CPT CODE: $375.4645334-2
CPT CODE: $315.7745335-2
CPT CODE: $879.4145337-2
CPT CODE: $373.2945338-2
CPT CODE: $190.9545340-2
CPT CODE: $458.5645341-2
CPT CODE: $481.9645342-2
CPT CODE: $351.2445346-2
CPT CODE: $397.4545346-4
CPT CODE: $241.1745347-2
CPT CODE: $272.9145347-4
CPT CODE: $1,165.9445378-2
CPT CODE: $1,758.8445379-2
CPT CODE: $1,165.9445380-2
CPT CODE: $1,348.7845381-2
CPT CODE: $1,590.8645382-2
CPT CODE: $1,530.4945384-2
CPT CODE: $1,531.5545385-2
CPT CODE: $463.1245386-2
CPT CODE: $755.3245388-2
CPT CODE: $854.7145388-4
CPT CODE: $478.2345389-2
CPT CODE: $541.1645389-4
CPT CODE: $816.6145391-2
CPT CODE: $863.8745392-2
CPT CODE: $4,384.7145395-2
CPT CODE: $6,749.9445397-2
CPT CODE: $2,159.9845400-2
CPT CODE: $2,717.8945402-2
CPT CODE: $2,045.4045500-2
CPT CODE: $2,065.1045505-2
CPT CODE: $124.5045520-2
CPT CODE: $2,776.6045540-2
CPT CODE: $2,776.6045541-2
CPT CODE: $3,488.0245550-2
CPT CODE: $1,274.6745560-2
CPT CODE: $1,534.2045562-2
CPT CODE: $3,531.3245563-2
CPT CODE: $3,142.1945800-2
CPT CODE: $3,527.5345805-2
CPT CODE: $3,142.1945820-2
CPT CODE: $3,527.5345825-2
CPT CODE: $187.7345900-2
CPT CODE: $268.7745905-2
CPT CODE: $642.2745910-2
CPT CODE: $424.8845915-2
CPT CODE: $195.6145990-2
CPT CODE: $186.6846020-2
CPT CODE: $124.5046030-2
CPT CODE: $523.7046040-2
CPT CODE: $523.7046045-2
CPT CODE: $213.4246050-2
CPT CODE: $1,373.4646060-2
CPT CODE: $563.1946070-2
CPT CODE: $889.2846080-2
CPT CODE: $296.4346083-2
CPT CODE: $1,254.9146200-2
CPT CODE: $187.7346220-2
CPT CODE: $292.4946221-2
CPT CODE: $1,096.7846250-2
CPT CODE: $1,294.4146255-2
CPT CODE: $1,363.6046257-2
Page 24
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $1,620.4946258-2
CPT CODE: $2,302.3146260-2
CPT CODE: $2,460.3946261-2
CPT CODE: $2,460.3946262-2
CPT CODE: $759.3546270-2
CPT CODE: $1,660.0446275-2
CPT CODE: $2,005.8846280-2
CPT CODE: $563.1946285-2
CPT CODE: $2,006.2446288-2
CPT CODE: $231.2346320-2
CPT CODE: $75.1146500-2
CPT CODE: $402.2446505-2
CPT CODE: $116.6046600-2
CPT CODE: $187.7346604-2
CPT CODE: $185.7746606-2
CPT CODE: $316.2146608-2
CPT CODE: $247.0246610-2
CPT CODE: $246.3746611-2
CPT CODE: $513.8346612-2
CPT CODE: $254.9346614-2
CPT CODE: $255.7146615-2
CPT CODE: $2,272.6746700-2
CPT CODE: $3,142.1946705-2
CPT CODE: $463.1246706-2
CPT CODE: $771.8746707-2
CPT CODE: $1,693.0046710-2
CPT CODE: $3,526.5046712-2
CPT CODE: $2,776.6046715-2
CPT CODE: $2,776.6046716-2
CPT CODE: $2,569.1046730-2
CPT CODE: $5,039.3346735-2
CPT CODE: $5,661.8846740-2
CPT CODE: $5,655.2946742-2
CPT CODE: $5,655.2946744-2
CPT CODE: $5,655.2946746-2
CPT CODE: $5,922.9346748-2
CPT CODE: $2,213.3446750-2
CPT CODE: $3,013.7446751-2
CPT CODE: $3,013.7446753-2
CPT CODE: $1,324.0746754-2
CPT CODE: $2,519.6946760-2
CPT CODE: $2,786.4646761-2
CPT CODE: $124.5046900-2
CPT CODE: $124.5046910-2
CPT CODE: $175.8646916-2
CPT CODE: $179.8246917-2
CPT CODE: $179.8246922-2
CPT CODE: $1,106.7146924-2
CPT CODE: $290.0946930-2
CPT CODE: $185.7746940-2
CPT CODE: $124.5046942-2
CPT CODE: $148.2046945-2
CPT CODE: $316.2146946-2
CPT CODE: $1,050.1246947-2
CPT CODE: $345.8447000-2
CPT CODE: $345.8447001-2
CPT CODE: $3,142.1947010-2
CPT CODE: $3,150.0547015-2
CPT CODE: $2,065.1047100-2
CPT CODE: $3,853.6747120-2
CPT CODE: $5,879.2747122-2
CPT CODE: $5,879.2747125-2
CPT CODE: $5,879.2747130-2
CPT CODE: $13,191.2847135-2
CPT CODE: $2,588.8747350-2
CPT CODE: $3,527.5347360-2
CPT CODE: $3,008.9047361-2
CPT CODE: $2,681.8647362-2
CPT CODE: $8,789.6447383-2
CPT CODE: $3,774.5847400-2
CPT CODE: $3,685.6547420-2
CPT CODE: $4,584.8647425-2
CPT CODE: $4,327.9347460-2
CPT CODE: $2,460.3947480-2
CPT CODE: $1,017.7547490-2
CPT CODE: $109.0747531-2
CPT CODE: $245.8947532-2
CPT CODE: $347.5647533-2
CPT CODE: $460.9847534-2
CPT CODE: $263.9047535-2
CPT CODE: $168.4647536-2
CPT CODE: $112.4747537-2
CPT CODE: $375.9747538-2
CPT CODE: $508.7047539-2
CPT CODE: $607.7047540-2
CPT CODE: $322.2647541-2
CPT CODE: $147.7747542-2
CPT CODE: $186.3547543-2
CPT CODE: $241.0447544-2
CPT CODE: $513.8347550-2
CPT CODE: $513.8347552-2
CPT CODE: $760.8347553-2
CPT CODE: $2,638.2647554-2
CPT CODE: $760.8347555-2
CPT CODE: $760.8347556-2
CPT CODE: $1,860.0547562-2
CPT CODE: $2,086.4947563-2
CPT CODE: $2,793.3147564-2
CPT CODE: $2,272.4947570-2
CPT CODE: $2,480.1447600-2
CPT CODE: $2,687.6547605-2
CPT CODE: $3,053.2647610-2
CPT CODE: $4,901.0447620-2
CPT CODE: $3,389.2147700-2
CPT CODE: $3,438.6447701-2
CPT CODE: $3,395.1547711-2
CPT CODE: $3,395.1547712-2
CPT CODE: $3,389.2147715-2
CPT CODE: $3,468.2747720-2
CPT CODE: $4,100.6547721-2
CPT CODE: $4,100.6547740-2
CPT CODE: $4,893.0347741-2
CPT CODE: $3,438.6447760-2
CPT CODE: $4,100.6547765-2
CPT CODE: $5,108.5147780-2
CPT CODE: $5,110.9147785-2
CPT CODE: $4,723.1747800-2
CPT CODE: $3,438.6447801-2
CPT CODE: $3,468.2747802-2
CPT CODE: $4,720.5647900-2
CPT CODE: $2,519.6948000-2
CPT CODE: $4,367.4348001-2
CPT CODE: $2,826.0248020-2
CPT CODE: $2,638.2648100-2
CPT CODE: $316.2148102-2
CPT CODE: $2,765.8648105-2
CPT CODE: $3,142.1948120-2
CPT CODE: $3,626.3448140-2
CPT CODE: $4,159.9548145-2
CPT CODE: $5,104.6848146-2
CPT CODE: $3,142.1948148-2
CPT CODE: $5,108.5148150-2
CPT CODE: $5,104.6848152-2
CPT CODE: $5,104.6848153-2
CPT CODE: $5,104.6848154-2
CPT CODE: $5,039.3348155-2
CPT CODE: $13,191.2848160-2
CPT CODE: $201.5748400-2
CPT CODE: $3,142.1948500-2
CPT CODE: $3,142.1948510-2
CPT CODE: $3,448.4948520-2
CPT CODE: $4,327.9348540-2
CPT CODE: $3,639.5248545-2
CPT CODE: $4,386.1048547-2
CPT CODE: $3,347.3848548-2
CPT CODE: $2,213.3449000-2
CPT CODE: $3,142.1949002-2
CPT CODE: $2,519.6949010-2
CPT CODE: $2,065.1049020-2
CPT CODE: $2,460.3949040-2
CPT CODE: $2,065.1049060-2
CPT CODE: $1,974.8449062-2
Page 25
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $233.8649082-2
CPT CODE: $440.7249083-2
CPT CODE: $142.9849084-2
CPT CODE: $361.1649180-2
CPT CODE: $140.0149185-2
CPT CODE: $1,710.1149203-2
CPT CODE: $1,874.4049204-2
CPT CODE: $2,146.0549205-2
CPT CODE: $5,661.8849215-2
CPT CODE: $4,446.4749220-2
CPT CODE: $1,452.5049250-2
CPT CODE: $2,065.1049255-2
CPT CODE: $1,067.4949320-2
CPT CODE: $1,334.3849321-2
CPT CODE: $1,384.5249322-2
CPT CODE: $1,509.0749323-2
CPT CODE: $926.9049324-2
CPT CODE: $1,068.5749325-2
CPT CODE: $553.1849326-2
CPT CODE: $230.9449327-2
CPT CODE: $316.2149400-2
CPT CODE: $1,418.0149402-2
CPT CODE: $252.0749405-2
CPT CODE: $252.4649406-2
CPT CODE: $286.6549407-2
CPT CODE: $690.8349411-2
CPT CODE: $143.9249412-2
CPT CODE: $1,963.2349418-2
CPT CODE: $1,239.0249419-2
CPT CODE: $1,215.3849421-2
CPT CODE: $1,216.4549422-2
CPT CODE: $229.7549423-2
CPT CODE: $114.8649424-2
CPT CODE: $1,936.7049425-2
CPT CODE: $899.1649426-2
CPT CODE: $363.4849427-2
CPT CODE: $907.7949428-2
CPT CODE: $907.7949429-2
CPT CODE: $354.8449435-2
CPT CODE: $425.0049436-2
CPT CODE: $798.1449440-2
CPT CODE: $870.5849441-2
CPT CODE: $723.1149442-2
CPT CODE: $571.7649446-2
CPT CODE: $231.5549450-2
CPT CODE: $319.5149451-2
CPT CODE: $498.0349452-2
CPT CODE: $162.9949460-2
CPT CODE: $107.3649465-2
CPT CODE: $1,635.3249491-2
CPT CODE: $2,738.3949492-2
CPT CODE: $1,707.7849495-2
CPT CODE: $2,855.6349496-2
CPT CODE: $1,709.4349500-2
CPT CODE: $2,855.6349501-2
CPT CODE: $1,440.6749505-2
CPT CODE: $2,855.6349507-2
CPT CODE: $1,877.4049520-2
CPT CODE: $2,855.6349521-2
CPT CODE: $1,551.3449525-2
CPT CODE: $2,084.8849540-2
CPT CODE: $1,531.5549550-2
CPT CODE: $1,577.1249553-2
CPT CODE: $2,154.1049555-2
CPT CODE: $1,745.1349557-2
CPT CODE: $1,995.9949560-2
CPT CODE: $1,997.0849561-2
CPT CODE: $2,588.8749565-2
CPT CODE: $938.6849570-2
CPT CODE: $1,679.7749572-2
CPT CODE: $1,245.0249580-2
CPT CODE: $1,250.5049582-2
CPT CODE: $1,763.7849585-2
CPT CODE: $1,763.7849587-2
CPT CODE: $2,005.8849590-2
CPT CODE: $2,203.4849600-2
CPT CODE: $3,468.2749605-2
CPT CODE: $2,203.4849606-2
CPT CODE: $2,776.6049610-2
CPT CODE: $2,776.6049611-2
CPT CODE: $1,433.0449650-2
CPT CODE: $1,586.7049651-2
CPT CODE: $1,512.8949652-2
CPT CODE: $1,888.2549653-2
CPT CODE: $1,735.9849654-2
CPT CODE: $2,090.0249655-2
CPT CODE: $1,742.8249656-2
CPT CODE: $2,516.4049657-2
CPT CODE: $1,027.6549900-2
CPT CODE: $2,745.6749904-2
CPT CODE: $2,582.6649905-2
CPT CODE: $6,329.9849906-2
CPT CODE: $2,569.1050010-2
CPT CODE: $2,114.5450020-2
CPT CODE: $3,142.1950040-2
CPT CODE: $3,142.1950045-2
CPT CODE: $3,142.1950060-2
CPT CODE: $4,406.9450065-2
CPT CODE: $4,406.9450070-2
CPT CODE: $4,604.6050075-2
CPT CODE: $4,051.2550080-2
CPT CODE: $5,108.5150081-2
CPT CODE: $2,519.6950100-2
CPT CODE: $3,142.1950120-2
CPT CODE: $3,142.1950125-2
CPT CODE: $3,102.6750130-2
CPT CODE: $4,406.9450135-2
CPT CODE: $820.1350200-2
CPT CODE: $1,432.7750205-2
CPT CODE: $3,102.6750220-2
CPT CODE: $4,031.4850225-2
CPT CODE: $4,713.2850230-2
CPT CODE: $4,713.2850234-2
CPT CODE: $4,031.4850236-2
CPT CODE: $3,744.9350240-2
CPT CODE: $3,705.4250280-2
CPT CODE: $3,705.4250290-2
CPT CODE: $1,936.7050300-2
CPT CODE: $4,406.9450320-2
CPT CODE: $3,646.1050340-2
CPT CODE: $7,391.1050360-2
CPT CODE: $9,110.3750365-2
CPT CODE: $2,638.2650370-2
CPT CODE: $5,533.4150380-2
CPT CODE: $337.5150382-2
CPT CODE: $304.4450384-2
CPT CODE: $285.8850385-2
CPT CODE: $216.0350386-2
CPT CODE: $121.2350387-2
CPT CODE: $96.4350389-2
CPT CODE: $306.3050390-2
CPT CODE: $194.8450391-2
CPT CODE: $124.5050396-2
CPT CODE: $3,893.1850400-2
CPT CODE: $4,397.0650405-2
CPT CODE: $189.7950430-2
CPT CODE: $74.8550431-2
CPT CODE: $251.1250432-2
CPT CODE: $310.2550433-2
CPT CODE: $237.5150434-2
CPT CODE: $114.8150435-2
CPT CODE: $162.0050436-2
CPT CODE: $271.2050437-2
CPT CODE: $3,142.1950500-2
CPT CODE: $4,100.6550520-2
CPT CODE: $4,406.9450525-2
CPT CODE: $4,406.9450526-2
CPT CODE: $5,148.0350540-2
CPT CODE: $1,384.5250541-2
CPT CODE: $3,144.1450542-2
CPT CODE: $3,183.2450543-2
CPT CODE: $3,194.4450544-2
Page 26
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $4,148.8650545-2
CPT CODE: $3,424.0950546-2
CPT CODE: $2,835.3750548-2
CPT CODE: $1,758.8450551-2
CPT CODE: $513.8350553-2
CPT CODE: $513.8350555-2
CPT CODE: $563.1950557-2
CPT CODE: $513.8350561-2
CPT CODE: $1,442.0150562-2
CPT CODE: $251.0050570-2
CPT CODE: $316.2150572-2
CPT CODE: $316.2150574-2
CPT CODE: $2,211.3850575-2
CPT CODE: $316.2150576-2
CPT CODE: $316.2150580-2
CPT CODE: $2,460.3950590-2
CPT CODE: $911.9750593-2
CPT CODE: $3,082.8950600-2
CPT CODE: $1,827.9850605-2
CPT CODE: $179.0850606-2
CPT CODE: $3,646.1050610-2
CPT CODE: $3,339.8250620-2
CPT CODE: $3,646.1050630-2
CPT CODE: $3,646.1050650-2
CPT CODE: $4,100.6550660-2
CPT CODE: $51.3850684-2
CPT CODE: $124.5050686-2
CPT CODE: $124.5050688-2
CPT CODE: $71.1650690-2
CPT CODE: $248.7150693-2
CPT CODE: $321.6550694-2
CPT CODE: $407.8850695-2
CPT CODE: $3,843.7450700-2
CPT CODE: $229.0250705-2
CPT CODE: $213.6950706-2
CPT CODE: $3,646.1050715-2
CPT CODE: $2,885.2750722-2
CPT CODE: $4,723.1750725-2
CPT CODE: $3,491.4350727-2
CPT CODE: $3,491.4350728-2
CPT CODE: $3,774.5850740-2
CPT CODE: $4,406.9450750-2
CPT CODE: $3,488.0250760-2
CPT CODE: $4,100.6550770-2
CPT CODE: $3,488.0250780-2
CPT CODE: $3,606.1950782-2
CPT CODE: $3,606.1950783-2
CPT CODE: $4,051.2550785-2
CPT CODE: $3,774.5850800-2
CPT CODE: $5,533.4150810-2
CPT CODE: $5,533.4150815-2
CPT CODE: $5,533.4150820-2
CPT CODE: $6,887.1150825-2
CPT CODE: $5,533.4150830-2
CPT CODE: $5,533.4150840-2
CPT CODE: $4,367.4350845-2
CPT CODE: $3,389.2150860-2
CPT CODE: $3,646.1050900-2
CPT CODE: $3,646.1050920-2
CPT CODE: $4,406.9450930-2
CPT CODE: $3,646.1050940-2
CPT CODE: $3,238.1050945-2
CPT CODE: $3,852.5150947-2
CPT CODE: $3,077.3350948-2
CPT CODE: $444.6550951-2
CPT CODE: $513.8350953-2
CPT CODE: $513.8350955-2
CPT CODE: $513.8350957-2
CPT CODE: $513.8350961-2
CPT CODE: $187.7350970-2
CPT CODE: $316.2150972-2
CPT CODE: $316.2150974-2
CPT CODE: $316.2150976-2
CPT CODE: $316.2150980-2
CPT CODE: $2,401.0951020-2
CPT CODE: $2,401.0951030-2
CPT CODE: $2,401.0951040-2
CPT CODE: $1,660.0451045-2
CPT CODE: $1,936.7051050-2
CPT CODE: $3,329.9451060-2
CPT CODE: $2,065.1051065-2
CPT CODE: $1,254.9151080-2
CPT CODE: $133.2451100-2
CPT CODE: $42.6951101-2
CPT CODE: $258.7251102-2
CPT CODE: $2,638.2651500-2
CPT CODE: $2,964.3651520-2
CPT CODE: $3,102.6751525-2
CPT CODE: $2,885.2751530-2
CPT CODE: $2,826.0251535-2
CPT CODE: $2,569.1051550-2
CPT CODE: $3,646.1051555-2
CPT CODE: $4,406.9451565-2
CPT CODE: $4,723.1751570-2
CPT CODE: $6,284.3851575-2
CPT CODE: $6,284.3851580-2
CPT CODE: $7,865.3651585-2
CPT CODE: $8,171.6851590-2
CPT CODE: $9,436.4451595-2
CPT CODE: $9,288.2551596-2
CPT CODE: $9,436.4451597-2
CPT CODE: $51.3851600-2
CPT CODE: $102.7651605-2
CPT CODE: $102.7651610-2
CPT CODE: $63.2151700-2
CPT CODE: $12.0351701-2
CPT CODE: $36.0851702-2
CPT CODE: $72.1751703-2
CPT CODE: $124.5051705-2
CPT CODE: $124.5051710-2
CPT CODE: $541.2651715-2
CPT CODE: $100.8051720-2
CPT CODE: $177.8451725-2
CPT CODE: $233.1951726-2
CPT CODE: $531.3151727-2
CPT CODE: $531.3151728-2
CPT CODE: $536.4551729-2
CPT CODE: $116.6051736-2
CPT CODE: $126.4951741-2
CPT CODE: $179.7351784-2
CPT CODE: $335.9551785-2
CPT CODE: $165.9951792-2
CPT CODE: $316.2151797-2
CPT CODE: $136.8351798-2
CPT CODE: $3,646.1051800-2
CPT CODE: $5,533.4151820-2
CPT CODE: $2,697.5051840-2
CPT CODE: $2,816.0951841-2
CPT CODE: $2,331.9651845-2
CPT CODE: $2,519.6951860-2
CPT CODE: $3,646.1051865-2
CPT CODE: $1,511.8151880-2
CPT CODE: $3,942.5451900-2
CPT CODE: $3,646.1051920-2
CPT CODE: $3,646.1051925-2
CPT CODE: $4,406.9451940-2
CPT CODE: $5,533.4151960-2
CPT CODE: $3,646.1051980-2
CPT CODE: $2,138.2351990-2
CPT CODE: $2,752.8751992-2
CPT CODE: $316.2152000-2
CPT CODE: $290.0452001-2
CPT CODE: $543.4652005-2
CPT CODE: $602.7552007-2
CPT CODE: $602.7552010-2
CPT CODE: $671.9252204-2
CPT CODE: $563.1952214-2
CPT CODE: $513.8352224-2
CPT CODE: $1,017.7552234-2
CPT CODE: $1,788.4552235-2
CPT CODE: $2,569.1052240-2
CPT CODE: $523.7052250-2
Page 27
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $444.6552260-2
CPT CODE: $268.7752265-2
CPT CODE: $760.8352270-2
CPT CODE: $760.8352275-2
CPT CODE: $1,146.2352276-2
CPT CODE: $1,126.4652277-2
CPT CODE: $563.1952281-2
CPT CODE: $1,064.2852282-2
CPT CODE: $513.8352283-2
CPT CODE: $671.9252285-2
CPT CODE: $367.0052287-2
CPT CODE: $711.4452290-2
CPT CODE: $1,027.6552300-2
CPT CODE: $993.7752301-2
CPT CODE: $1,126.4652305-2
CPT CODE: $582.9852310-2
CPT CODE: $820.1352315-2
CPT CODE: $1,827.9852317-2
CPT CODE: $2,519.6952318-2
CPT CODE: $1,165.9452320-2
CPT CODE: $2,203.4852325-2
CPT CODE: $544.6952327-2
CPT CODE: $889.2852330-2
CPT CODE: $879.4152332-2
CPT CODE: $1,096.7852334-2
CPT CODE: $692.5152341-2
CPT CODE: $761.1452342-2
CPT CODE: $831.3452343-2
CPT CODE: $836.0152344-2
CPT CODE: $920.2352345-2
CPT CODE: $1,002.9152346-2
CPT CODE: $667.5652351-2
CPT CODE: $2,027.6452352-2
CPT CODE: $2,409.7852353-2
CPT CODE: $1,558.1752354-2
CPT CODE: $1,486.4252355-2
CPT CODE: $1,363.1252356-2
CPT CODE: $879.6852400-2
CPT CODE: $808.0152402-2
CPT CODE: $1,438.2652441-2
CPT CODE: $1,103.3852442-2
CPT CODE: $1,966.3152500-2
CPT CODE: $3,092.7852601-2
CPT CODE: $3,646.1052630-2
CPT CODE: $1,827.9852640-2
CPT CODE: $3,095.6052647-2
CPT CODE: $3,095.6052648-2
CPT CODE: $2,085.2552649-2
CPT CODE: $1,254.9152700-2
CPT CODE: $523.7053000-2
CPT CODE: $1,571.0953010-2
CPT CODE: $296.4353020-2
CPT CODE: $124.5053025-2
CPT CODE: $563.1953040-2
CPT CODE: $249.0153060-2
CPT CODE: $760.8353080-2
CPT CODE: $3,646.1053085-2
CPT CODE: $365.5853200-2
CPT CODE: $2,638.2653210-2
CPT CODE: $3,339.8253215-2
CPT CODE: $2,272.6753220-2
CPT CODE: $2,331.9653230-2
CPT CODE: $2,519.6953235-2
CPT CODE: $760.8353240-2
CPT CODE: $2,272.6753250-2
CPT CODE: $185.7753260-2
CPT CODE: $444.6553265-2
CPT CODE: $316.2153270-2
CPT CODE: $563.1953275-2
CPT CODE: $1,827.9853400-2
CPT CODE: $2,134.3253405-2
CPT CODE: $2,885.2753410-2
CPT CODE: $2,845.7253415-2
CPT CODE: $3,646.1053420-2
CPT CODE: $3,646.1053425-2
CPT CODE: $2,163.9553430-2
CPT CODE: $2,198.4353431-2
CPT CODE: $3,646.1053440-2
CPT CODE: $1,827.9853442-2
CPT CODE: $1,672.3453444-2
CPT CODE: $4,268.6653445-2
CPT CODE: $1,485.6753446-2
CPT CODE: $2,134.3253447-2
CPT CODE: $2,042.6053448-2
CPT CODE: $2,134.3253449-2
CPT CODE: $741.0853450-2
CPT CODE: $563.1953460-2
CPT CODE: $1,308.8853500-2
CPT CODE: $2,519.6953502-2
CPT CODE: $1,887.2953505-2
CPT CODE: $2,519.6953510-2
CPT CODE: $3,646.1053515-2
CPT CODE: $820.1353520-2
CPT CODE: $79.0253600-2
CPT CODE: $75.1153601-2
CPT CODE: $268.7753605-2
CPT CODE: $100.8053620-2
CPT CODE: $100.8053621-2
CPT CODE: $67.1753660-2
CPT CODE: $65.2053661-2
CPT CODE: $181.8153665-2
CPT CODE: $1,800.8553850-2
CPT CODE: $771.8753855-2
CPT CODE: $2,877.8853860-2
CPT CODE: $124.5054000-2
CPT CODE: $177.8454001-2
CPT CODE: $251.0054015-2
CPT CODE: $110.6754050-2
CPT CODE: $128.4454055-2
CPT CODE: $118.5954056-2
CPT CODE: $909.0454057-2
CPT CODE: $258.8954060-2
CPT CODE: $375.4654065-2
CPT CODE: $124.5054100-2
CPT CODE: $316.2154105-2
CPT CODE: $1,571.0954110-2
CPT CODE: $2,519.6954111-2
CPT CODE: $3,389.2154112-2
CPT CODE: $938.6854115-2
CPT CODE: $1,887.2954120-2
CPT CODE: $3,774.5854125-2
CPT CODE: $5,414.8554130-2
CPT CODE: $6,541.2854135-2
CPT CODE: $148.2054150-2
CPT CODE: $136.3754160-2
CPT CODE: $731.2154161-2
CPT CODE: $475.1654162-2
CPT CODE: $442.7754163-2
CPT CODE: $379.5254164-2
CPT CODE: $124.5054200-2
CPT CODE: $1,571.0954205-2
CPT CODE: $1,314.1754220-2
CPT CODE: $124.5054230-2
CPT CODE: $80.2354231-2
CPT CODE: $81.0454235-2
CPT CODE: $81.0454240-2
CPT CODE: $88.9154250-2
CPT CODE: $1,571.0954300-2
CPT CODE: $2,638.2654304-2
CPT CODE: $1,571.0954308-2
CPT CODE: $1,571.0954312-2
CPT CODE: $2,638.2654316-2
CPT CODE: $2,638.2654318-2
CPT CODE: $3,033.4954322-2
CPT CODE: $3,132.2854324-2
CPT CODE: $3,132.2854326-2
CPT CODE: $4,189.6154328-2
CPT CODE: $3,962.2954332-2
CPT CODE: $3,962.2954336-2
CPT CODE: $1,827.9854340-2
CPT CODE: $3,132.2854344-2
CPT CODE: $3,596.7154348-2
Page 28
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $3,962.2954352-2
CPT CODE: $1,620.4954360-2
CPT CODE: $2,638.2654380-2
CPT CODE: $3,329.9454385-2
CPT CODE: $3,329.9454390-2
CPT CODE: $2,756.8254400-2
CPT CODE: $3,310.1654401-2
CPT CODE: $4,258.7554405-2
CPT CODE: $2,229.2854406-2
CPT CODE: $2,436.0154408-2
CPT CODE: $2,786.2054410-2
CPT CODE: $3,065.4554411-2
CPT CODE: $1,086.1054415-2
CPT CODE: $1,447.0954416-2
CPT CODE: $1,592.1254417-2
CPT CODE: $2,331.9654420-2
CPT CODE: $2,331.9654430-2
CPT CODE: $1,571.0954435-2
CPT CODE: $760.1154437-2
CPT CODE: $1,534.2454438-2
CPT CODE: $1,660.0454440-2
CPT CODE: $187.7354450-2
CPT CODE: $102.7654500-2
CPT CODE: $494.0554505-2
CPT CODE: $851.6254512-2
CPT CODE: $997.9854520-2
CPT CODE: $967.0354522-2
CPT CODE: $2,075.0254530-2
CPT CODE: $2,776.6054535-2
CPT CODE: $1,571.0954550-2
CPT CODE: $2,331.9654560-2
CPT CODE: $1,314.1754600-2
CPT CODE: $760.8354620-2
CPT CODE: $1,758.8454640-2
CPT CODE: $1,745.1354650-2
CPT CODE: $760.8354660-2
CPT CODE: $1,571.0954670-2
CPT CODE: $1,887.2954680-2
CPT CODE: $912.2354690-2
CPT CODE: $1,599.6454692-2
CPT CODE: $484.1754700-2
CPT CODE: $124.5054800-2
CPT CODE: $1,017.7554830-2
CPT CODE: $1,333.9454840-2
CPT CODE: $1,225.2454860-2
CPT CODE: $1,887.2954861-2
CPT CODE: $774.4454865-2
CPT CODE: $1,887.2954900-2
CPT CODE: $2,638.2654901-2
CPT CODE: $104.7355000-2
CPT CODE: $1,254.9155040-2
CPT CODE: $1,788.4555041-2
CPT CODE: $1,126.4655060-2
CPT CODE: $316.2155100-2
CPT CODE: $1,561.2355110-2
CPT CODE: $316.2155120-2
CPT CODE: $1,610.6055150-2
CPT CODE: $2,272.6755175-2
CPT CODE: $2,272.6755180-2
CPT CODE: $582.9855200-2
CPT CODE: $573.0855250-2
CPT CODE: $691.6955300-2
CPT CODE: $1,610.6055400-2
CPT CODE: $1,156.0855500-2
CPT CODE: $1,017.7555520-2
CPT CODE: $1,580.9655530-2
CPT CODE: $1,679.7755535-2
CPT CODE: $1,808.2455540-2
CPT CODE: $1,277.7755550-2
CPT CODE: $622.5055600-2
CPT CODE: $1,630.3755605-2
CPT CODE: $3,774.5855650-2
CPT CODE: $3,774.5855680-2
CPT CODE: $464.3855700-2
CPT CODE: $1,571.0955705-2
CPT CODE: $1,571.0955720-2
CPT CODE: $2,638.2655725-2
CPT CODE: $4,011.7355801-2
CPT CODE: $5,355.5755810-2
CPT CODE: $5,355.5755812-2
CPT CODE: $7,114.3655815-2
CPT CODE: $4,011.7355821-2
CPT CODE: $4,011.7355831-2
CPT CODE: $5,355.5755840-2
CPT CODE: $5,355.5755842-2
CPT CODE: $5,938.5455845-2
CPT CODE: $1,827.9855860-2
CPT CODE: $2,519.6955862-2
CPT CODE: $4,219.2155865-2
CPT CODE: $45.4555870-2
CPT CODE: $1,302.3755873-2
CPT CODE: $1,208.8955875-2
CPT CODE: $267.1555876-2
CPT CODE: $662.3155920-2
CPT CODE: $306.0956405-2
CPT CODE: $179.8256420-2
CPT CODE: $780.6056440-2
CPT CODE: $592.8756441-2
CPT CODE: $143.0256442-2
CPT CODE: $213.4256501-2
CPT CODE: $839.9156515-2
CPT CODE: $306.0956605-2
CPT CODE: $59.3156606-2
CPT CODE: $2,351.7256620-2
CPT CODE: $3,013.7456625-2
CPT CODE: $3,438.6456630-2
CPT CODE: $4,687.0556631-2
CPT CODE: $4,694.0656632-2
CPT CODE: $3,424.4456633-2
CPT CODE: $4,687.0556634-2
CPT CODE: $4,687.0556637-2
CPT CODE: $5,908.9056640-2
CPT CODE: $444.6556700-2
CPT CODE: $879.4156740-2
CPT CODE: $444.6556800-2
CPT CODE: $405.1156805-2
CPT CODE: $927.8656810-2
CPT CODE: $196.9856820-2
CPT CODE: $269.1556821-2
CPT CODE: $602.7557000-2
CPT CODE: $592.8757010-2
CPT CODE: $124.5057020-2
CPT CODE: $399.3057022-2
CPT CODE: $399.3057023-2
CPT CODE: $592.8757061-2
CPT CODE: $691.6957065-2
CPT CODE: $128.4457100-2
CPT CODE: $573.0857105-2
CPT CODE: $1,677.7357106-2
CPT CODE: $2,097.9757107-2
CPT CODE: $2,516.5857109-2
CPT CODE: $2,638.2657110-2
CPT CODE: $3,086.3357111-2
CPT CODE: $3,702.6157112-2
CPT CODE: $2,401.0957120-2
CPT CODE: $622.5057130-2
CPT CODE: $474.2757135-2
CPT CODE: $100.8057150-2
CPT CODE: $626.3557155-2
CPT CODE: $232.5857156-2
CPT CODE: $116.6057160-2
CPT CODE: $73.1057170-2
CPT CODE: $187.7357180-2
CPT CODE: $444.6557200-2
CPT CODE: $484.1757210-2
CPT CODE: $1,571.0957220-2
CPT CODE: $1,571.0957230-2
CPT CODE: $1,245.0257240-2
CPT CODE: $1,037.5057250-2
CPT CODE: $1,294.4157260-2
CPT CODE: $1,729.1857265-2
CPT CODE: $2,331.9657268-2
Page 29
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $2,045.4057270-2
CPT CODE: $2,331.9657280-2
CPT CODE: $2,351.7257282-2
CPT CODE: $1,928.3357283-2
CPT CODE: $2,582.8557284-2
CPT CODE: $1,372.4957285-2
CPT CODE: $1,327.3357287-2
CPT CODE: $3,013.7457288-2
CPT CODE: $2,173.8457289-2
CPT CODE: $2,519.6957291-2
CPT CODE: $2,519.6957292-2
CPT CODE: $1,177.8057295-2
CPT CODE: $1,787.6957296-2
CPT CODE: $2,885.2757300-2
CPT CODE: $3,468.2757305-2
CPT CODE: $4,100.6557307-2
CPT CODE: $2,753.6457308-2
CPT CODE: $2,519.6957310-2
CPT CODE: $2,499.9257311-2
CPT CODE: $3,468.2757320-2
CPT CODE: $3,468.2757330-2
CPT CODE: $2,341.8357335-2
CPT CODE: $235.1557400-2
CPT CODE: $251.0057410-2
CPT CODE: $246.8057415-2
CPT CODE: $196.9857420-2
CPT CODE: $269.1557421-2
CPT CODE: $1,961.0757423-2
CPT CODE: $1,950.7757425-2
CPT CODE: $1,488.4357426-2
CPT CODE: $211.4557452-2
CPT CODE: $326.0757454-2
CPT CODE: $221.0357455-2
CPT CODE: $210.5157456-2
CPT CODE: $717.4257460-2
CPT CODE: $750.3357461-2
CPT CODE: $169.9657500-2
CPT CODE: $316.2157505-2
CPT CODE: $165.9957510-2
CPT CODE: $211.4557511-2
CPT CODE: $1,017.7557513-2
CPT CODE: $978.2357520-2
CPT CODE: $980.4257522-2
CPT CODE: $889.2857530-2
CPT CODE: $5,304.5357531-2
CPT CODE: $2,519.6957540-2
CPT CODE: $2,826.0257545-2
CPT CODE: $2,331.9657550-2
CPT CODE: $2,776.6057555-2
CPT CODE: $2,776.6057556-2
CPT CODE: $497.8557558-2
CPT CODE: $839.9157700-2
CPT CODE: $1,126.4657720-2
CPT CODE: $185.7757800-2
CPT CODE: $195.6558100-2
CPT CODE: $77.1458110-2
CPT CODE: $652.1958120-2
CPT CODE: $2,539.4358140-2
CPT CODE: $2,450.5158145-2
CPT CODE: $2,090.0858146-2
CPT CODE: $2,608.6258150-2
CPT CODE: $3,478.1658152-2
CPT CODE: $3,043.3758180-2
CPT CODE: $3,073.0258200-2
CPT CODE: $6,541.2858210-2
CPT CODE: $9,130.1358240-2
CPT CODE: $2,796.3458260-2
CPT CODE: $3,127.9058262-2
CPT CODE: $3,309.6458263-2
CPT CODE: $3,685.6558267-2
CPT CODE: $3,201.4658270-2
CPT CODE: $3,191.6058275-2
CPT CODE: $3,438.6458280-2
CPT CODE: $5,602.5758285-2
CPT CODE: $1,515.6958290-2
CPT CODE: $1,666.0558291-2
CPT CODE: $1,831.4558292-2
CPT CODE: $2,668.9958293-2
CPT CODE: $2,323.1458294-2
CPT CODE: $185.7758300-2
CPT CODE: $73.1058301-2
CPT CODE: $181.8158340-2
CPT CODE: $241.0658345-2
CPT CODE: $683.4558346-2
CPT CODE: $128.4458350-2
CPT CODE: $758.0358353-2
CPT CODE: $800.8558356-2
CPT CODE: $2,065.1058400-2
CPT CODE: $2,964.3658410-2
CPT CODE: $2,045.4058520-2
CPT CODE: $2,816.0958540-2
CPT CODE: $1,928.0258541-2
CPT CODE: $2,021.1158542-2
CPT CODE: $1,928.0258543-2
CPT CODE: $2,021.1158544-2
CPT CODE: $1,287.1358545-2
CPT CODE: $1,287.1358546-2
CPT CODE: $4,985.3158548-2
CPT CODE: $1,792.1058550-2
CPT CODE: $1,666.0558552-2
CPT CODE: $1,515.6958553-2
CPT CODE: $1,666.0558554-2
CPT CODE: $582.2858555-2
CPT CODE: $800.6458558-2
CPT CODE: $1,143.5258559-2
CPT CODE: $1,143.5258560-2
CPT CODE: $1,143.5258561-2
CPT CODE: $944.5858562-2
CPT CODE: $1,310.1358563-2
CPT CODE: $1,549.7158570-2
CPT CODE: $1,672.5958571-2
CPT CODE: $1,549.7158572-2
CPT CODE: $1,672.5958573-2
CPT CODE: $823.3558575-2
CPT CODE: $1,314.1758600-2
CPT CODE: $1,225.2458605-2
CPT CODE: $1,175.8658615-2
CPT CODE: $1,180.7458660-2
CPT CODE: $2,023.4158661-2
CPT CODE: $1,384.5258662-2
CPT CODE: $1,400.7058670-2
CPT CODE: $1,334.3858671-2
CPT CODE: $1,439.5058672-2
CPT CODE: $1,400.7058673-2
CPT CODE: $1,482.1558700-2
CPT CODE: $2,213.3458720-2
CPT CODE: $2,509.7958740-2
CPT CODE: $4,920.7958750-2
CPT CODE: $3,942.5458752-2
CPT CODE: $3,942.5458760-2
CPT CODE: $3,942.5458770-2
CPT CODE: $879.4158800-2
CPT CODE: $2,282.5058805-2
CPT CODE: $879.4158820-2
CPT CODE: $2,272.6758822-2
CPT CODE: $3,942.5458825-2
CPT CODE: $2,065.1058900-2
CPT CODE: $2,045.4058920-2
CPT CODE: $1,887.2958925-2
CPT CODE: $1,926.8058940-2
CPT CODE: $3,280.5158943-2
CPT CODE: $2,717.3058950-2
CPT CODE: $4,229.1258951-2
CPT CODE: $3,912.9058952-2
CPT CODE: $4,193.2158953-2
CPT CODE: $4,469.3658954-2
CPT CODE: $3,393.9258956-2
CPT CODE: $2,968.2458957-2
CPT CODE: $3,306.9058958-2
CPT CODE: $4,446.4758960-2
CPT CODE: $162.0359000-3
CPT CODE: $421.1859001-2
Page 30
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $162.0359012-3
CPT CODE: $162.0359015-3
CPT CODE: $134.3859020-3
CPT CODE: $102.7659025-3
CPT CODE: $187.7359030-3
CPT CODE: $21.7659050-3
CPT CODE: $25.3859051-3
CPT CODE: $2,638.2659100-3
CPT CODE: $2,588.8759120-3
CPT CODE: $2,806.2259121-3
CPT CODE: $2,588.8759130-3
CPT CODE: $3,082.8959135-3
CPT CODE: $2,954.4259136-3
CPT CODE: $2,648.1459140-3
CPT CODE: $1,511.8159150-3
CPT CODE: $2,539.4359151-3
CPT CODE: $760.8359160-3
CPT CODE: $415.0059200-3
CPT CODE: $1,017.7559300-3
CPT CODE: $839.9159320-3
CPT CODE: $839.9159325-3
CPT CODE: $2,588.8759350-3
CPT CODE: $3,537.4359400-3
CPT CODE: $2,174.4059409-3
CPT CODE: $2,242.9959410-3
CPT CODE: $625.2959425-3
CPT CODE: $942.5759426-3
CPT CODE: $69.1559430-3
CPT CODE: $3,537.4359510-3
CPT CODE: $2,883.6359514-3
CPT CODE: $2,954.4259515-3
CPT CODE: $1,403.1459525-3
CPT CODE: $3,533.9659610-3
CPT CODE: $2,174.4759612-3
CPT CODE: $2,238.1259614-3
CPT CODE: $3,533.9659618-3
CPT CODE: $2,881.6159620-3
CPT CODE: $2,945.2459622-3
CPT CODE: $770.7359812-3
CPT CODE: $978.2359820-3
CPT CODE: $978.2359821-3
CPT CODE: $1,432.7759830-3
CPT CODE: $642.2759840-3
CPT CODE: $731.2159841-3
CPT CODE: $1,531.5559850-3
CPT CODE: $1,660.0459851-3
CPT CODE: $2,638.2659852-3
CPT CODE: $1,225.5359855-3
CPT CODE: $1,325.3959856-3
CPT CODE: $2,115.1959857-2
CPT CODE: $1,115.6459866-3
CPT CODE: $731.2159870-3
CPT CODE: $805.8359871-3
CPT CODE: $622.5060000-2
CPT CODE: $187.7360100-2
CPT CODE: $1,531.5560200-2
CPT CODE: $2,423.8360210-2
CPT CODE: $2,659.8460212-2
CPT CODE: $2,302.3160220-2
CPT CODE: $2,460.3960225-2
CPT CODE: $2,835.8860240-2
CPT CODE: $3,853.6760252-2
CPT CODE: $5,167.8260254-2
CPT CODE: $3,082.8960260-2
CPT CODE: $4,100.6560270-2
CPT CODE: $3,104.6760271-2
CPT CODE: $2,173.8460280-2
CPT CODE: $2,114.5460281-2
CPT CODE: $156.5260300-2
CPT CODE: $3,250.8760500-2
CPT CODE: $3,231.1060502-2
CPT CODE: $4,100.6560505-2
CPT CODE: $653.6060512-2
CPT CODE: $4,100.6560520-2
CPT CODE: $4,103.2460521-2
CPT CODE: $4,103.2460522-2
CPT CODE: $3,962.2960540-2
CPT CODE: $4,584.8660545-2
CPT CODE: $3,468.2760600-2
CPT CODE: $4,901.0460605-2
CPT CODE: $3,623.0660650-2
CPT CODE: $513.8361000-2
CPT CODE: $444.6561001-2
CPT CODE: $306.3061020-2
CPT CODE: $444.6561026-2
CPT CODE: $251.0061050-2
CPT CODE: $345.8461055-2
CPT CODE: $306.3061070-2
CPT CODE: $1,254.9161105-2
CPT CODE: $4,406.9461107-2
CPT CODE: $3,972.2061108-2
CPT CODE: $1,254.9161120-2
CPT CODE: $3,468.2761140-2
CPT CODE: $4,100.6561150-2
CPT CODE: $365.5861151-2
CPT CODE: $4,140.1761154-2
CPT CODE: $4,406.9461156-2
CPT CODE: $4,426.7361210-2
CPT CODE: $2,203.4861215-2
CPT CODE: $2,272.6761250-2
CPT CODE: $2,776.6061253-2
CPT CODE: $5,908.9061304-2
CPT CODE: $6,748.7861305-2
CPT CODE: $5,385.2261312-2
CPT CODE: $5,385.2261313-2
CPT CODE: $4,841.7461314-2
CPT CODE: $4,841.7461315-2
CPT CODE: $721.7661316-2
CPT CODE: $5,148.0361320-2
CPT CODE: $5,148.0361321-2
CPT CODE: $4,569.6161322-2
CPT CODE: $5,656.7561323-2
CPT CODE: $4,406.9461330-2
CPT CODE: $4,406.9461333-2
CPT CODE: $2,717.3061340-2
CPT CODE: $7,677.6261343-2
CPT CODE: $3,468.2761345-2
CPT CODE: $4,841.7461450-2
CPT CODE: $5,908.9061458-2
CPT CODE: $5,908.9061460-2
CPT CODE: $6,294.2661500-2
CPT CODE: $6,294.2661501-2
CPT CODE: $7,341.6661510-2
CPT CODE: $6,926.6661512-2
CPT CODE: $6,047.2461514-2
CPT CODE: $6,047.2461516-2
CPT CODE: $863.0961517-2
CPT CODE: $7,242.8661518-2
CPT CODE: $7,549.1561519-2
CPT CODE: $7,539.2861520-2
CPT CODE: $7,173.6761521-2
CPT CODE: $6,047.2461522-2
CPT CODE: $6,047.2461524-2
CPT CODE: $6,047.2461526-2
CPT CODE: $8,310.0161530-2
CPT CODE: $4,208.8161531-2
CPT CODE: $8,883.1261533-2
CPT CODE: $6,047.2461534-2
CPT CODE: $5,908.9061535-2
CPT CODE: $6,165.8461536-2
CPT CODE: $5,217.7961537-2
CPT CODE: $6,659.8761538-2
CPT CODE: $6,659.8761539-2
CPT CODE: $5,273.8561540-2
CPT CODE: $8,112.3961541-2
CPT CODE: $8,112.3961543-2
CPT CODE: $5,148.0361544-2
CPT CODE: $7,341.6661545-2
CPT CODE: $5,908.9061546-2
CPT CODE: $6,189.6561548-2
CPT CODE: $3,636.2461550-2
CPT CODE: $5,148.0361552-2
Page 31
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $3,468.2761556-2
CPT CODE: $3,468.2761557-2
CPT CODE: $4,772.5661558-2
CPT CODE: $4,772.5661559-2
CPT CODE: $5,780.4361563-2
CPT CODE: $8,221.0861564-2
CPT CODE: $5,740.1661566-2
CPT CODE: $6,314.1761567-2
CPT CODE: $5,908.9061570-2
CPT CODE: $5,908.9061571-2
CPT CODE: $2,134.3261575-2
CPT CODE: $2,134.3261576-2
CPT CODE: $2,053.0661580-2
CPT CODE: $3,816.8461581-2
CPT CODE: $3,359.5761582-2
CPT CODE: $3,406.2261583-2
CPT CODE: $2,165.0761584-2
CPT CODE: $2,603.6961585-2
CPT CODE: $2,102.5761586-2
CPT CODE: $2,874.2661590-2
CPT CODE: $2,361.0361591-2
CPT CODE: $1,913.1061592-2
CPT CODE: $2,361.0361595-2
CPT CODE: $2,827.6561596-2
CPT CODE: $3,686.2361597-2
CPT CODE: $3,648.8861598-2
CPT CODE: $3,359.5761600-2
CPT CODE: $3,359.5761601-2
CPT CODE: $3,359.5761605-2
CPT CODE: $3,359.5761606-2
CPT CODE: $4,488.7761607-2
CPT CODE: $4,488.7761608-2
CPT CODE: $2,267.7361611-2
CPT CODE: $4,376.7761613-2
CPT CODE: $3,686.2361615-2
CPT CODE: $4,526.1061616-2
CPT CODE: $2,510.3461618-2
CPT CODE: $1,689.1261619-2
CPT CODE: $2,676.5261623-2
CPT CODE: $3,497.9061624-2
CPT CODE: $1,057.2761626-2
CPT CODE: $868.6561645-2
CPT CODE: $592.1861650-2
CPT CODE: $252.1061651-2
CPT CODE: $7,015.5661680-2
CPT CODE: $8,171.6861682-2
CPT CODE: $7,015.5661684-2
CPT CODE: $8,171.6861686-2
CPT CODE: $7,015.5661690-2
CPT CODE: $8,171.6861692-2
CPT CODE: $7,202.7961697-2
CPT CODE: $7,202.7961698-2
CPT CODE: $7,015.5661700-2
CPT CODE: $8,171.6861702-2
CPT CODE: $6,985.9261703-2
CPT CODE: $6,985.9261705-2
CPT CODE: $6,985.9261708-2
CPT CODE: $6,985.9261710-2
CPT CODE: $6,985.9261711-2
CPT CODE: $6,610.4461720-2
CPT CODE: $6,610.4461735-2
CPT CODE: $6,610.4461750-2
CPT CODE: $6,610.4461751-2
CPT CODE: $6,313.2161760-2
CPT CODE: $6,610.4461770-2
CPT CODE: $319.7761781-2
CPT CODE: $319.7761782-2
CPT CODE: $319.7761783-2
CPT CODE: $2,717.3061790-2
CPT CODE: $4,268.6661791-2
CPT CODE: $1,544.1261796-2
CPT CODE: $421.8161797-2
CPT CODE: $1,544.1261798-2
CPT CODE: $583.2361799-2
CPT CODE: $299.2361800-2
CPT CODE: $4,387.2061850-2
CPT CODE: $4,841.7461860-2
CPT CODE: $2,158.8361863-2
CPT CODE: $647.8061864-2
CPT CODE: $2,877.4561867-2
CPT CODE: $863.2461868-2
CPT CODE: $1,818.1561880-2
CPT CODE: $1,818.1561885-2
CPT CODE: $1,665.9561886-2
CPT CODE: $1,818.1561888-2
CPT CODE: $3,310.1662000-2
CPT CODE: $4,090.7762005-2
CPT CODE: $4,713.2862010-2
CPT CODE: $5,148.0362100-2
CPT CODE: $4,772.5662115-2
CPT CODE: $4,772.5662117-2
CPT CODE: $4,841.7462120-2
CPT CODE: $4,733.0162121-2
CPT CODE: $3,339.8262140-2
CPT CODE: $4,100.6562141-2
CPT CODE: $3,646.1062142-2
CPT CODE: $3,646.1062143-2
CPT CODE: $4,723.1762145-2
CPT CODE: $3,280.5162146-2
CPT CODE: $3,873.4062147-2
CPT CODE: $765.3662148-2
CPT CODE: $936.7862160-2
CPT CODE: $3,738.0862161-2
CPT CODE: $4,112.4962162-2
CPT CODE: $3,363.6862163-2
CPT CODE: $4,859.8162164-2
CPT CODE: $5,025.2262165-2
CPT CODE: $4,970.1962180-2
CPT CODE: $4,100.6562190-2
CPT CODE: $3,774.5862192-2
CPT CODE: $1,077.0362194-2
CPT CODE: $5,464.2262200-2
CPT CODE: $5,464.2262201-2
CPT CODE: $4,406.9462220-2
CPT CODE: $4,090.7762223-2
CPT CODE: $1,077.0362225-2
CPT CODE: $1,768.7262230-2
CPT CODE: $109.1762252-2
CPT CODE: $1,758.8462256-2
CPT CODE: $2,075.0262258-2
CPT CODE: $1,103.0962263-2
CPT CODE: $717.2562264-2
CPT CODE: $333.4962267-2
CPT CODE: $187.7362268-2
CPT CODE: $187.7362269-2
CPT CODE: $181.8162270-2
CPT CODE: $142.2962272-2
CPT CODE: $484.1762273-2
CPT CODE: $375.4662280-2
CPT CODE: $928.8262281-2
CPT CODE: $375.4662282-2
CPT CODE: $417.9562284-2
CPT CODE: $3,814.1062287-2
CPT CODE: $415.0062290-2
CPT CODE: $415.0062291-2
CPT CODE: $3,685.6562292-2
CPT CODE: $879.4162294-2
CPT CODE: $288.0562302-2
CPT CODE: $298.9862303-2
CPT CODE: $283.7862304-2
CPT CODE: $149.6662305-2
CPT CODE: $263.7362320-2
CPT CODE: $292.3562321-2
CPT CODE: $233.2462322-2
CPT CODE: $265.2062323-2
CPT CODE: $212.4662324-2
CPT CODE: $265.4362325-2
CPT CODE: $221.3562326-2
CPT CODE: $237.8362327-2
CPT CODE: $94.0762328-2
CPT CODE: $116.9662329-2
CPT CODE: $2,238.1262350-2
Page 32
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $4,430.2862351-2
CPT CODE: $371.2662355-2
CPT CODE: $5,627.0962360-2
CPT CODE: $5,627.0962361-2
CPT CODE: $5,627.0962362-2
CPT CODE: $2,812.6962365-2
CPT CODE: $40.5662367-2
CPT CODE: $40.5662368-2
CPT CODE: $134.3362369-2
CPT CODE: $141.7762370-2
CPT CODE: $5,108.5163001-2
CPT CODE: $5,286.3963003-2
CPT CODE: $4,387.2063005-2
CPT CODE: $4,387.2063011-2
CPT CODE: $5,424.7063012-2
CPT CODE: $6,284.3863015-2
CPT CODE: $6,284.3863016-2
CPT CODE: $5,404.9663017-2
CPT CODE: $4,496.8763020-2
CPT CODE: $3,810.2063030-2
CPT CODE: $1,043.1763035-2
CPT CODE: $5,236.2463040-2
CPT CODE: $5,305.1263042-2
CPT CODE: $895.2963043-2
CPT CODE: $895.2963044-2
CPT CODE: $5,236.2463045-2
CPT CODE: $5,286.3963046-2
CPT CODE: $4,047.1963047-2
CPT CODE: $915.9863048-2
CPT CODE: $5,343.7463050-2
CPT CODE: $5,852.3363051-2
CPT CODE: $5,286.3963055-2
CPT CODE: $4,387.2063056-2
CPT CODE: $1,017.7563057-2
CPT CODE: $5,464.2263064-2
CPT CODE: $1,254.9163066-2
CPT CODE: $4,402.6763075-2
CPT CODE: $1,077.0363076-2
CPT CODE: $4,772.5663077-2
CPT CODE: $1,067.1563078-2
CPT CODE: $6,294.2663081-2
CPT CODE: $1,571.0963082-2
CPT CODE: $6,294.2663085-2
CPT CODE: $1,571.0963086-2
CPT CODE: $6,294.2663087-2
CPT CODE: $1,571.0963088-2
CPT CODE: $6,294.2663090-2
CPT CODE: $1,571.0963091-2
CPT CODE: $5,511.4363101-2
CPT CODE: $5,511.4363102-2
CPT CODE: $1,373.8063103-2
CPT CODE: $5,464.2263170-2
CPT CODE: $5,671.7763172-2
CPT CODE: $5,671.7763173-2
CPT CODE: $6,659.8763180-2
CPT CODE: $7,677.6263182-2
CPT CODE: $4,841.7463185-2
CPT CODE: $5,839.7363190-2
CPT CODE: $5,464.2263191-2
CPT CODE: $5,464.2263194-2
CPT CODE: $5,464.2263195-2
CPT CODE: $5,464.2263196-2
CPT CODE: $5,464.2263197-2
CPT CODE: $6,985.9263198-2
CPT CODE: $6,985.9263199-2
CPT CODE: $6,393.0563200-2
CPT CODE: $6,659.8763250-2
CPT CODE: $6,659.8763251-2
CPT CODE: $6,659.8763252-2
CPT CODE: $5,671.7763265-2
CPT CODE: $5,898.9763266-2
CPT CODE: $5,148.0363267-2
CPT CODE: $5,148.0363268-2
CPT CODE: $5,908.9063270-2
CPT CODE: $5,898.9763271-2
CPT CODE: $5,148.0363272-2
CPT CODE: $5,148.0363273-2
CPT CODE: $5,908.9063275-2
CPT CODE: $5,898.9763276-2
CPT CODE: $5,148.0363277-2
CPT CODE: $5,148.0363278-2
CPT CODE: $5,908.9063280-2
CPT CODE: $5,898.9763281-2
CPT CODE: $5,148.0363282-2
CPT CODE: $5,148.0363283-2
CPT CODE: $5,908.9063285-2
CPT CODE: $5,898.9763286-2
CPT CODE: $5,898.9763287-2
CPT CODE: $5,898.9763290-2
CPT CODE: $1,110.2963295-2
CPT CODE: $6,294.2663300-2
CPT CODE: $6,165.8463301-2
CPT CODE: $6,294.2663302-2
CPT CODE: $6,294.2663303-2
CPT CODE: $6,294.2663304-2
CPT CODE: $6,294.2663305-2
CPT CODE: $6,294.2663306-2
CPT CODE: $6,294.2663307-2
CPT CODE: $1,571.0963308-2
CPT CODE: $2,717.3063600-2
CPT CODE: $1,017.7563610-2
CPT CODE: $1,544.1263620-2
CPT CODE: $485.0163621-2
CPT CODE: $2,717.3063650-2
CPT CODE: $4,100.6563655-2
CPT CODE: $796.3263661-2
CPT CODE: $1,201.5563662-2
CPT CODE: $1,354.6563663-2
CPT CODE: $1,251.7263664-2
CPT CODE: $3,389.2163685-2
CPT CODE: $3,389.2163688-2
CPT CODE: $3,013.7463700-2
CPT CODE: $3,774.5863702-2
CPT CODE: $4,140.1763704-2
CPT CODE: $3,774.5863706-2
CPT CODE: $5,039.3363707-2
CPT CODE: $6,432.5963709-2
CPT CODE: $5,039.3363710-2
CPT CODE: $4,406.9463740-2
CPT CODE: $3,389.2163741-2
CPT CODE: $1,758.8463744-2
CPT CODE: $1,758.8463746-2
CPT CODE: $71.1664400-2
CPT CODE: $102.7664405-2
CPT CODE: $124.5064408-2
CPT CODE: $124.5064415-2
CPT CODE: $213.5264416-2
CPT CODE: $124.5064417-2
CPT CODE: $124.5064418-2
CPT CODE: $177.8464420-2
CPT CODE: $306.3064421-2
CPT CODE: $185.7764425-2
CPT CODE: $251.0064430-2
CPT CODE: $110.6764435-2
CPT CODE: $124.5064445-2
CPT CODE: $213.5264446-2
CPT CODE: $106.7664447-2
CPT CODE: $2,168.2764448-2
CPT CODE: $209.5464449-2
CPT CODE: $179.8264450-2
CPT CODE: $83.5864451-2
CPT CODE: $82.2464455-2
CPT CODE: $98.6364461-2
CPT CODE: $61.9464462-2
CPT CODE: $97.2964463-2
CPT CODE: $302.4764479-2
CPT CODE: $126.1664480-2
CPT CODE: $262.0164483-2
CPT CODE: $105.1464484-2
CPT CODE: $146.6564486-2
CPT CODE: $179.2264487-2
CPT CODE: $180.7864488-2
Page 33
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $249.7864489-2
CPT CODE: $337.0564490-2
CPT CODE: $164.6664491-2
CPT CODE: $144.0864492-2
CPT CODE: $313.9064493-2
CPT CODE: $149.2364494-2
CPT CODE: $129.9364495-2
CPT CODE: $187.7364505-2
CPT CODE: $326.0764510-2
CPT CODE: $317.2564517-2
CPT CODE: $365.5864520-2
CPT CODE: $104.7364530-2
CPT CODE: $2,025.6164553-2
CPT CODE: $2,025.6164555-2
CPT CODE: $1,771.0864561-2
CPT CODE: $216.0364566-2
CPT CODE: $1,135.6164568-2
CPT CODE: $1,001.2464569-2
CPT CODE: $866.5864570-2
CPT CODE: $2,509.7964575-2
CPT CODE: $2,509.7964580-2
CPT CODE: $2,190.7064581-2
CPT CODE: $1,254.9164585-2
CPT CODE: $2,509.7964590-2
CPT CODE: $1,254.9164595-2
CPT CODE: $444.6564600-2
CPT CODE: $563.1964605-2
CPT CODE: $691.6964610-2
CPT CODE: $162.3664611-2
CPT CODE: $1,215.3864612-2
CPT CODE: $210.4964615-2
CPT CODE: $189.9864616-2
CPT CODE: $235.9264617-2
CPT CODE: $251.0064620-2
CPT CODE: $365.5864630-2
CPT CODE: $133.1964632-2
CPT CODE: $490.3964633-2
CPT CODE: $223.6464634-2
CPT CODE: $482.0064635-2
CPT CODE: $201.2764636-2
CPT CODE: $365.5864640-2
CPT CODE: $121.5664642-2
CPT CODE: $81.7464643-2
CPT CODE: $132.8964644-2
CPT CODE: $93.5464645-2
CPT CODE: $131.6364646-2
CPT CODE: $152.0764647-2
CPT CODE: $406.3864650-0
CPT CODE: $406.3864653-2
CPT CODE: $513.8364680-2
CPT CODE: $453.0264681-2
CPT CODE: $820.1364702-2
CPT CODE: $1,156.0864704-2
CPT CODE: $1,748.9764708-2
CPT CODE: $2,075.0264712-2
CPT CODE: $2,519.6964713-2
CPT CODE: $1,748.9764714-2
CPT CODE: $1,748.9764716-2
CPT CODE: $1,936.7064718-2
CPT CODE: $1,195.5964719-2
CPT CODE: $1,182.7664721-2
CPT CODE: $1,729.1864722-2
CPT CODE: $820.1364726-2
CPT CODE: $1,195.5964732-2
CPT CODE: $1,195.5964734-2
CPT CODE: $1,195.5964736-2
CPT CODE: $1,758.8464738-2
CPT CODE: $1,758.8464740-2
CPT CODE: $1,758.8464742-2
CPT CODE: $1,383.3364744-2
CPT CODE: $938.6864746-2
CPT CODE: $2,826.0264755-2
CPT CODE: $2,401.0964760-2
CPT CODE: $1,077.0364763-2
CPT CODE: $1,758.8464766-2
CPT CODE: $2,272.6764771-2
CPT CODE: $3,774.5864772-2
CPT CODE: $513.8364774-2
CPT CODE: $1,887.2964776-2
CPT CODE: $251.0064778-2
CPT CODE: $849.7764782-2
CPT CODE: $1,758.8464784-2
CPT CODE: $1,758.8464786-2
CPT CODE: $1,156.0864787-2
CPT CODE: $849.7764788-2
CPT CODE: $1,571.0964790-2
CPT CODE: $1,571.0964792-2
CPT CODE: $375.4664795-2
CPT CODE: $2,519.6964802-2
CPT CODE: $3,468.2764804-2
CPT CODE: $3,468.2764809-2
CPT CODE: $2,420.8764818-2
CPT CODE: $835.1764820-2
CPT CODE: $910.2264821-2
CPT CODE: $91.0464822-2
CPT CODE: $947.2564823-2
CPT CODE: $830.0264831-2
CPT CODE: $249.0164832-2
CPT CODE: $1,156.0864834-2
CPT CODE: $1,521.7164835-2
CPT CODE: $1,748.9764836-2
CPT CODE: $573.0864837-2
CPT CODE: $1,748.9764840-2
CPT CODE: $2,075.0264856-2
CPT CODE: $1,995.9964857-2
CPT CODE: $1,748.9764858-2
CPT CODE: $573.0864859-2
CPT CODE: $2,401.0964861-2
CPT CODE: $2,401.0964862-2
CPT CODE: $4,406.9464864-2
CPT CODE: $4,406.9464865-2
CPT CODE: $4,406.9464866-2
CPT CODE: $4,406.9464868-2
CPT CODE: $2,075.0264885-2
CPT CODE: $2,075.0264886-2
CPT CODE: $2,075.0264890-2
CPT CODE: $2,075.0264891-2
CPT CODE: $3,142.1964892-2
CPT CODE: $3,142.1964893-2
CPT CODE: $4,041.3764895-2
CPT CODE: $4,041.3764896-2
CPT CODE: $6,234.9864897-2
CPT CODE: $6,234.9864898-2
CPT CODE: $1,571.0964901-2
CPT CODE: $2,075.0264902-2
CPT CODE: $1,857.6864905-2
CPT CODE: $1,857.6864907-2
CPT CODE: $982.2264910-2
CPT CODE: $1,238.5764911-2
CPT CODE: $1,857.6865091-2
CPT CODE: $2,401.0965093-2
CPT CODE: $2,213.3465101-2
CPT CODE: $2,440.6465103-2
CPT CODE: $3,142.1965105-2
CPT CODE: $3,843.7465110-2
CPT CODE: $3,843.7465112-2
CPT CODE: $4,723.1765114-2
CPT CODE: $1,936.7065130-2
CPT CODE: $2,331.9665135-2
CPT CODE: $2,312.1765140-2
CPT CODE: $1,936.7065150-2
CPT CODE: $2,312.1765155-2
CPT CODE: $978.2365175-2
CPT CODE: $94.8665205-2
CPT CODE: $88.9165210-2
CPT CODE: $104.7365220-2
CPT CODE: $110.6765222-2
CPT CODE: $3,389.2165235-2
CPT CODE: $2,025.6165260-2
CPT CODE: $3,142.1965265-2
CPT CODE: $185.7765270-2
CPT CODE: $316.2165272-2
Page 34
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $316.2165273-2
CPT CODE: $100.8065275-2
CPT CODE: $1,887.2965280-2
CPT CODE: $2,203.4865285-2
CPT CODE: $1,887.2965286-2
CPT CODE: $760.8365290-2
CPT CODE: $1,017.7565400-2
CPT CODE: $187.7365410-2
CPT CODE: $760.8365420-2
CPT CODE: $770.7365426-2
CPT CODE: $124.5065430-2
CPT CODE: $114.6365435-2
CPT CODE: $187.7365436-2
CPT CODE: $306.3065450-2
CPT CODE: $1,571.0965600-2
CPT CODE: $4,980.0865710-2
CPT CODE: $5,661.8865730-2
CPT CODE: $5,108.5165750-2
CPT CODE: $5,602.5765755-2
CPT CODE: $2,092.3165756-2
CPT CODE: $3,685.6565760-2
CPT CODE: $5,908.9065765-2
CPT CODE: $6,234.9865770-2
CPT CODE: $3,046.6865771-2
CPT CODE: $1,511.8165772-2
CPT CODE: $2,075.0265775-2
CPT CODE: $1,635.5065778-2
CPT CODE: $1,542.5665779-2
CPT CODE: $4,152.3965780-2
CPT CODE: $4,983.1765781-2
CPT CODE: $4,567.0465782-2
CPT CODE: $689.9965785-2
CPT CODE: $187.7365800-2
CPT CODE: $1,571.0965810-2
CPT CODE: $1,017.7565815-2
CPT CODE: $2,272.6765820-2
CPT CODE: $1,422.8965850-2
CPT CODE: $1,472.2965855-2
CPT CODE: $2,228.7465860-2
CPT CODE: $2,331.9665865-2
CPT CODE: $1,936.7065870-2
CPT CODE: $1,936.7065875-2
CPT CODE: $1,936.7065880-2
CPT CODE: $1,936.7065900-2
CPT CODE: $1,294.4165920-2
CPT CODE: $2,203.4865930-2
CPT CODE: $820.1366020-2
CPT CODE: $938.6866030-2
CPT CODE: $2,075.0266130-2
CPT CODE: $2,717.3066150-2
CPT CODE: $2,717.3066155-2
CPT CODE: $2,717.3066160-2
CPT CODE: $2,213.3466170-2
CPT CODE: $2,211.7466172-2
CPT CODE: $1,612.3966174-2
CPT CODE: $1,763.1366175-2
CPT CODE: $1,091.8266179-2
CPT CODE: $2,144.2266180-2
CPT CODE: $1,222.1266183-2
CPT CODE: $760.1466184-2
CPT CODE: $2,144.2266185-2
CPT CODE: $4,723.1766225-2
CPT CODE: $1,679.7766250-2
CPT CODE: $1,017.7566500-2
CPT CODE: $1,017.7566505-2
CPT CODE: $2,213.3466600-2
CPT CODE: $4,327.9366605-2
CPT CODE: $1,936.7066625-2
CPT CODE: $1,936.7066630-2
CPT CODE: $1,936.7066635-2
CPT CODE: $2,114.5466680-2
CPT CODE: $1,245.0266682-2
CPT CODE: $2,104.6966700-2
CPT CODE: $2,104.6966710-2
CPT CODE: $2,104.6966720-2
CPT CODE: $2,104.6966740-2
CPT CODE: $1,205.4666761-2
CPT CODE: $1,195.5966762-2
CPT CODE: $1,551.3466770-2
CPT CODE: $1,403.1466820-2
CPT CODE: $997.9866821-2
CPT CODE: $2,467.8966825-2
CPT CODE: $1,640.2566830-2
CPT CODE: $3,073.0266840-2
CPT CODE: $4,130.2966850-2
CPT CODE: $4,772.5666852-2
CPT CODE: $2,816.0966920-2
CPT CODE: $2,648.1466930-2
CPT CODE: $2,618.4766940-2
CPT CODE: $1,712.5666982-2
CPT CODE: $3,675.7666983-2
CPT CODE: $3,675.7666984-2
CPT CODE: $2,262.7866985-2
CPT CODE: $3,675.7666986-2
CPT CODE: $347.3566990-2
CPT CODE: $2,045.4067005-2
CPT CODE: $2,816.0967010-2
CPT CODE: $1,571.0967015-2
CPT CODE: $2,331.9667025-2
CPT CODE: $1,481.5667027-2
CPT CODE: $523.7067028-2
CPT CODE: $2,065.1067030-2
CPT CODE: $2,065.1067031-2
CPT CODE: $4,169.8467036-2
CPT CODE: $4,584.8667039-2
CPT CODE: $4,792.3267040-2
CPT CODE: $2,823.8967041-2
CPT CODE: $3,233.9567042-2
CPT CODE: $3,393.0767043-2
CPT CODE: $4,199.4567101-2
CPT CODE: $4,199.4567105-2
CPT CODE: $3,853.6767107-2
CPT CODE: $4,891.1267108-2
CPT CODE: $2,213.3467110-2
CPT CODE: $3,971.3067113-2
CPT CODE: $1,887.2967115-2
CPT CODE: $2,203.4867120-2
CPT CODE: $2,203.4867121-2
CPT CODE: $1,709.4367141-2
CPT CODE: $1,966.3167145-2
CPT CODE: $2,371.4467208-2
CPT CODE: $1,966.3167210-2
CPT CODE: $2,450.5167218-2
CPT CODE: $2,230.8767220-2
CPT CODE: $722.1767221-2
CPT CODE: $357.9267225-2
CPT CODE: $2,677.7667227-2
CPT CODE: $1,966.3167228-2
CPT CODE: $1,452.6967229-2
CPT CODE: $3,843.7467250-2
CPT CODE: $4,723.1767255-2
CPT CODE: $1,926.8067311-2
CPT CODE: $1,926.8067312-2
CPT CODE: $2,628.3867314-2
CPT CODE: $2,746.9567316-2
CPT CODE: $2,628.3867318-2
CPT CODE: $2,796.3467320-2
CPT CODE: $2,776.6067331-2
CPT CODE: $1,907.0467332-2
CPT CODE: $2,628.3867334-2
CPT CODE: $563.1967335-2
CPT CODE: $3,280.5167340-2
CPT CODE: $2,628.3867343-2
CPT CODE: $1,383.3367345-2
CPT CODE: $665.1567346-2
CPT CODE: $2,539.4367400-2
CPT CODE: $2,075.0267405-2
CPT CODE: $2,727.2067412-2
CPT CODE: $1,887.2967413-2
CPT CODE: $3,843.7467414-2
CPT CODE: $365.5867415-2
CPT CODE: $4,327.9367420-2
Page 35
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $4,327.9367430-2
CPT CODE: $3,843.7467440-2
CPT CODE: $3,843.7467445-2
CPT CODE: $4,327.9367450-2
CPT CODE: $126.4967500-2
CPT CODE: $365.5867505-2
CPT CODE: $108.6967515-2
CPT CODE: $2,717.3067550-2
CPT CODE: $1,383.3367560-2
CPT CODE: $5,908.9067570-2
CPT CODE: $104.7367700-2
CPT CODE: $124.5067710-2
CPT CODE: $124.5067715-2
CPT CODE: $169.9667800-2
CPT CODE: $365.5867801-2
CPT CODE: $375.4667805-2
CPT CODE: $642.2767808-2
CPT CODE: $160.0767810-2
CPT CODE: $92.8467820-2
CPT CODE: $187.7367825-2
CPT CODE: $187.7367830-2
CPT CODE: $187.7367835-2
CPT CODE: $258.8967840-2
CPT CODE: $254.9367850-2
CPT CODE: $306.3067875-2
CPT CODE: $1,254.9167880-2
CPT CODE: $1,254.9167882-2
CPT CODE: $2,104.6967900-2
CPT CODE: $1,808.2467901-2
CPT CODE: $2,569.1067902-2
CPT CODE: $3,102.6767903-2
CPT CODE: $2,569.1067904-2
CPT CODE: $3,142.1967906-2
CPT CODE: $2,065.1067908-2
CPT CODE: $2,065.1067909-2
CPT CODE: $2,331.9667911-2
CPT CODE: $1,950.7767912-2
CPT CODE: $316.2167914-2
CPT CODE: $251.0067915-2
CPT CODE: $1,571.0967916-2
CPT CODE: $1,758.8467917-2
CPT CODE: $316.2167921-2
CPT CODE: $251.0067922-2
CPT CODE: $1,274.6767923-2
CPT CODE: $1,660.0467924-2
CPT CODE: $316.2167930-2
CPT CODE: $533.5967935-2
CPT CODE: $102.7667938-2
CPT CODE: $1,254.9167950-2
CPT CODE: $1,966.3167961-2
CPT CODE: $2,322.0567966-2
CPT CODE: $2,322.0567971-2
CPT CODE: $2,885.2767973-2
CPT CODE: $3,468.2767974-2
CPT CODE: $444.6567975-2
CPT CODE: $126.4968020-2
CPT CODE: $51.3868040-2
CPT CODE: $219.3468100-2
CPT CODE: $316.2168110-2
CPT CODE: $444.6568115-2
CPT CODE: $444.6568130-2
CPT CODE: $124.5068135-2
CPT CODE: $100.8068200-2
CPT CODE: $1,660.0468320-2
CPT CODE: $2,203.4868325-2
CPT CODE: $2,826.0268326-2
CPT CODE: $3,596.7168328-2
CPT CODE: $938.6868330-2
CPT CODE: $1,215.3868335-2
CPT CODE: $1,215.3868340-2
CPT CODE: $938.6868360-2
CPT CODE: $1,936.7068362-2
CPT CODE: $1,047.6868371-2
CPT CODE: $187.7368400-2
CPT CODE: $104.7368420-2
CPT CODE: $124.5068440-2
CPT CODE: $2,331.9668500-2
CPT CODE: $2,331.9668505-2
CPT CODE: $365.5868510-2
CPT CODE: $2,331.9668520-2
CPT CODE: $365.5868525-2
CPT CODE: $365.5868530-2
CPT CODE: $2,519.6968540-2
CPT CODE: $3,735.0868550-2
CPT CODE: $622.5068700-2
CPT CODE: $187.7368705-2
CPT CODE: $2,569.1068720-2
CPT CODE: $2,885.2768745-2
CPT CODE: $2,569.1068750-2
CPT CODE: $152.1668760-2
CPT CODE: $118.6168761-2
CPT CODE: $1,017.7568770-2
CPT CODE: $123.6068801-2
CPT CODE: $242.0268810-2
CPT CODE: $545.8068811-2
CPT CODE: $501.1768815-2
CPT CODE: $579.5268816-2
CPT CODE: $124.5068840-2
CPT CODE: $124.5068850-2
CPT CODE: $120.5369000-2
CPT CODE: $185.7769005-2
CPT CODE: $124.5069020-2
CPT CODE: $156.1269100-2
CPT CODE: $187.7369105-2
CPT CODE: $691.6969110-2
CPT CODE: $1,571.0969120-2
CPT CODE: $1,254.9169140-2
CPT CODE: $187.7369145-2
CPT CODE: $2,519.6969150-2
CPT CODE: $2,519.6969155-2
CPT CODE: $108.6969200-2
CPT CODE: $365.5869205-2
CPT CODE: $13.1669209-2
CPT CODE: $45.4569210-2
CPT CODE: $51.3869220-2
CPT CODE: $187.7369222-2
CPT CODE: $1,660.0469300-2
CPT CODE: $6,007.7169310-2
CPT CODE: $6,007.7169320-2
CPT CODE: $355.7569420-2
CPT CODE: $523.7069421-2
CPT CODE: $148.2069424-2
CPT CODE: $251.0069433-2
CPT CODE: $523.7069436-2
CPT CODE: $2,084.8869440-2
CPT CODE: $2,203.4869450-2
CPT CODE: $1,452.5069501-2
CPT CODE: $3,468.2769502-2
CPT CODE: $4,229.1269505-2
CPT CODE: $4,219.2169511-2
CPT CODE: $4,100.6569530-2
CPT CODE: $3,646.1069535-2
CPT CODE: $365.5869540-2
CPT CODE: $6,047.2469550-2
CPT CODE: $6,047.2469552-2
CPT CODE: $6,047.2469554-2
CPT CODE: $3,843.7469601-2
CPT CODE: $2,816.0969602-2
CPT CODE: $4,723.1769603-2
CPT CODE: $2,737.0769604-2
CPT CODE: $4,723.1769605-2
CPT CODE: $243.0869610-2
CPT CODE: $2,588.8769620-2
CPT CODE: $2,964.3669631-2
CPT CODE: $3,211.3469632-2
CPT CODE: $3,073.0269633-2
CPT CODE: $3,379.3369635-2
CPT CODE: $4,347.7069636-2
CPT CODE: $5,849.6369637-2
CPT CODE: $3,656.0169641-2
CPT CODE: $4,229.1269642-2
CPT CODE: $4,229.1269643-2
Page 36
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $4,308.1669644-2
CPT CODE: $4,456.3869645-2
CPT CODE: $6,096.6569646-2
CPT CODE: $2,035.5169650-2
CPT CODE: $2,845.7269660-2
CPT CODE: $4,525.5569661-2
CPT CODE: $1,422.8969662-2
CPT CODE: $4,525.5569666-2
CPT CODE: $4,525.5569667-2
CPT CODE: $4,841.7469670-2
CPT CODE: $4,841.7469676-2
CPT CODE: $1,571.0969700-2
CPT CODE: $4,090.7769710-2
CPT CODE: $2,075.0269711-2
CPT CODE: $5,414.8569720-2
CPT CODE: $5,414.8569725-2
CPT CODE: $6,610.4469740-2
CPT CODE: $6,610.4469745-2
CPT CODE: $3,774.5869801-2
CPT CODE: $3,774.5869805-2
CPT CODE: $3,744.9369806-2
CPT CODE: $4,525.5569905-2
CPT CODE: $4,525.5569910-2
CPT CODE: $5,908.9069915-2
CPT CODE: $6,610.4469930-2
CPT CODE: $5,908.9069950-2
CPT CODE: $5,908.9069955-2
CPT CODE: $5,908.9069960-2
CPT CODE: $5,908.9069970-2
CPT CODE: $582.9870010-5
CPT CODE: $229.2670010-P
CPT CODE: $582.9870015-5
CPT CODE: $229.2670015-P
CPT CODE: $160.0770030-5
CPT CODE: $51.3870030-P
CPT CODE: $94.8670100-5
CPT CODE: $43.4770100-P
CPT CODE: $124.5070110-5
CPT CODE: $59.2870110-P
CPT CODE: $94.8670120-5
CPT CODE: $45.4570120-P
CPT CODE: $104.7370130-5
CPT CODE: $65.2070130-P
CPT CODE: $142.2970134-5
CPT CODE: $65.2070134-P
CPT CODE: $71.1670140-5
CPT CODE: $49.3970140-P
CPT CODE: $124.5070150-5
CPT CODE: $63.2170150-P
CPT CODE: $75.1170160-5
CPT CODE: $43.4770160-P
CPT CODE: $162.0370170-5
CPT CODE: $61.2670170-P
CPT CODE: $96.8470190-5
CPT CODE: $55.3270190-P
CPT CODE: $108.6970200-5
CPT CODE: $61.2670200-P
CPT CODE: $66.6970210-5
CPT CODE: $25.9270210-P
CPT CODE: $116.6870220-5
CPT CODE: $48.1470220-P
CPT CODE: $75.1170240-5
CPT CODE: $35.5670240-P
CPT CODE: $98.8170250-5
CPT CODE: $47.4470250-P
CPT CODE: $148.2070260-5
CPT CODE: $67.1770260-P
CPT CODE: $47.4470300-5
CPT CODE: $13.8170300-P
CPT CODE: $65.2070310-5
CPT CODE: $19.7770310-P
CPT CODE: $88.9170320-5
CPT CODE: $37.5470320-P
CPT CODE: $96.8470328-5
CPT CODE: $45.4570328-P
CPT CODE: $118.5970330-5
CPT CODE: $61.2670330-P
CPT CODE: $181.8170332-5
CPT CODE: $98.8170332-P
CPT CODE: $968.3470336-5
CPT CODE: $335.9570336-P
CPT CODE: $154.1570350-5
CPT CODE: $64.1170350-P
CPT CODE: $75.1170355-5
CPT CODE: $57.3170355-P
CPT CODE: $79.0270360-5
CPT CODE: $41.4870360-P
CPT CODE: $134.3870370-5
CPT CODE: $45.4570370-P
CPT CODE: $75.1170380-5
CPT CODE: $39.5370380-P
CPT CODE: $160.0770390-5
CPT CODE: $51.3870390-P
CPT CODE: $436.7470450-5
CPT CODE: $162.9870450-P
CPT CODE: $484.1770460-5
CPT CODE: $181.4970460-P
CPT CODE: $588.8970470-5
CPT CODE: $220.4070470-P
CPT CODE: $399.4370480-5
CPT CODE: $162.9870480-P
CPT CODE: $464.7470481-5
CPT CODE: $188.9170481-P
CPT CODE: $553.7770482-5
CPT CODE: $225.9570482-P
CPT CODE: $390.3570486-5
CPT CODE: $159.2870486-P
CPT CODE: $453.8970487-5
CPT CODE: $185.2070487-P
CPT CODE: $553.7770488-5
CPT CODE: $272.7470488-P
CPT CODE: $399.4370490-5
CPT CODE: $162.9870490-P
CPT CODE: $464.7470491-5
CPT CODE: $188.9170491-P
CPT CODE: $553.7770492-5
CPT CODE: $225.9570492-P
CPT CODE: $581.7870496-5
CPT CODE: $174.6970496-P
CPT CODE: $594.2670498-5
CPT CODE: $177.8170498-P
CPT CODE: $968.3470540-5
CPT CODE: $335.9570540-P
CPT CODE: $751.7970542-5
CPT CODE: $226.1870542-P
CPT CODE: $996.6770543-5
CPT CODE: $299.4770543-P
CPT CODE: $764.2670544-5
CPT CODE: $229.2870544-P
CPT CODE: $834.4570545-5
CPT CODE: $251.1370545-P
CPT CODE: $1,107.4070546-5
CPT CODE: $332.2270546-P
CPT CODE: $726.8370547-5
CPT CODE: $218.3670547-P
CPT CODE: $792.3370548-5
CPT CODE: $237.0870548-P
CPT CODE: $1,052.8270549-5
CPT CODE: $316.6370549-P
CPT CODE: $968.3470551-5
CPT CODE: $335.9570551-P
CPT CODE: $971.3570552-5
CPT CODE: $335.9570552-P
CPT CODE: $1,289.0870553-5
CPT CODE: $335.9570553-P
CPT CODE: $376.4270554-5
CPT CODE: $256.3570554-P
CPT CODE: $388.5770555-5
CPT CODE: $256.3570555-P
CPT CODE: $295.1370557-P
CPT CODE: $308.4070558-P
CPT CODE: $323.1770559-P
Page 37
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $40.4671045-5
CPT CODE: $15.7371045-P
CPT CODE: $57.3271046-5
CPT CODE: $22.4871046-P
CPT CODE: $83.1771047-5
CPT CODE: $24.7371047-P
CPT CODE: $65.7571048-5
CPT CODE: $24.7371048-P
CPT CODE: $106.7271100-5
CPT CODE: $49.3971100-P
CPT CODE: $126.4971101-5
CPT CODE: $67.1771101-P
CPT CODE: $134.3871110-5
CPT CODE: $69.1571110-P
CPT CODE: $207.4871111-5
CPT CODE: $96.8471111-P
CPT CODE: $104.7371120-5
CPT CODE: $45.4571120-P
CPT CODE: $108.6971130-5
CPT CODE: $43.4771130-P
CPT CODE: $453.8971250-5
CPT CODE: $185.2071250-P
CPT CODE: $535.6071260-5
CPT CODE: $218.5371260-P
CPT CODE: $653.6071270-5
CPT CODE: $266.7171270-P
CPT CODE: $701.8871275-5
CPT CODE: $210.5671275-P
CPT CODE: $968.3471550-5
CPT CODE: $335.9571550-P
CPT CODE: $792.3371551-5
CPT CODE: $237.0871551-P
CPT CODE: $1,052.8271552-5
CPT CODE: $316.6371552-P
CPT CODE: $1,240.9071555-5
CPT CODE: $335.9571555-P
CPT CODE: $71.1672020-5
CPT CODE: $39.5372020-P
CPT CODE: $98.8172040-5
CPT CODE: $40.7472040-P
CPT CODE: $152.1672050-5
CPT CODE: $57.3172050-P
CPT CODE: $171.9372052-5
CPT CODE: $67.1772052-P
CPT CODE: $112.6472070-5
CPT CODE: $45.4572070-P
CPT CODE: $124.5072072-5
CPT CODE: $57.3172072-P
CPT CODE: $154.1572074-5
CPT CODE: $65.2072074-P
CPT CODE: $92.8472080-5
CPT CODE: $49.3972080-P
CPT CODE: $41.0772081-5
CPT CODE: $15.0272081-P
CPT CODE: $65.6472082-5
CPT CODE: $18.2072082-P
CPT CODE: $71.3672083-5
CPT CODE: $19.8672083-P
CPT CODE: $84.9172084-5
CPT CODE: $23.1072084-P
CPT CODE: $128.4472100-5
CPT CODE: $55.3272100-P
CPT CODE: $169.9672110-5
CPT CODE: $71.1672110-P
CPT CODE: $235.2172114-5
CPT CODE: $71.1672114-P
CPT CODE: $169.9672120-5
CPT CODE: $47.4472120-P
CPT CODE: $453.8972125-5
CPT CODE: $185.2072125-P
CPT CODE: $535.6072126-5
CPT CODE: $218.5372126-P
CPT CODE: $653.6072127-5
CPT CODE: $306.3072127-P
CPT CODE: $453.8972128-5
CPT CODE: $185.2072128-P
CPT CODE: $535.6072129-5
CPT CODE: $218.5372129-P
CPT CODE: $653.6072130-5
CPT CODE: $266.7172130-P
CPT CODE: $453.8972131-5
CPT CODE: $185.2072131-P
CPT CODE: $535.6072132-5
CPT CODE: $218.5372132-P
CPT CODE: $653.6072133-5
CPT CODE: $266.7172133-P
CPT CODE: $968.3472141-5
CPT CODE: $335.9572141-P
CPT CODE: $980.4272142-5
CPT CODE: $335.9572142-P
CPT CODE: $968.3472146-5
CPT CODE: $335.9572146-P
CPT CODE: $980.4272147-5
CPT CODE: $335.9572147-P
CPT CODE: $968.3472148-5
CPT CODE: $335.9572148-P
CPT CODE: $980.4272149-5
CPT CODE: $335.9572149-P
CPT CODE: $1,289.0872156-5
CPT CODE: $335.9572156-P
CPT CODE: $1,243.4772157-5
CPT CODE: $335.9572157-P
CPT CODE: $1,289.0872158-5
CPT CODE: $335.9572158-P
CPT CODE: $914.5372159-5
CPT CODE: $335.9572159-P
CPT CODE: $94.8672170-5
CPT CODE: $43.4772170-P
CPT CODE: $128.4472190-5
CPT CODE: $49.3972190-P
CPT CODE: $662.8872191-5
CPT CODE: $199.6572191-P
CPT CODE: $453.8972192-5
CPT CODE: $185.2072192-P
CPT CODE: $517.4672193-5
CPT CODE: $210.8072193-P
CPT CODE: $617.3272194-5
CPT CODE: $251.8672194-P
CPT CODE: $687.8472195-5
CPT CODE: $205.8972195-P
CPT CODE: $968.3472196-5
CPT CODE: $335.9572196-P
CPT CODE: $996.6772197-5
CPT CODE: $299.4772197-P
CPT CODE: $914.5372198-5
CPT CODE: $335.9572198-P
CPT CODE: $108.6972200-5
CPT CODE: $35.5672200-P
CPT CODE: $120.5372202-5
CPT CODE: $43.4772202-P
CPT CODE: $100.8072220-5
CPT CODE: $43.4772220-P
CPT CODE: $484.1772240-5
CPT CODE: $171.9372240-P
CPT CODE: $484.1772255-5
CPT CODE: $177.8472255-P
CPT CODE: $484.1772265-5
CPT CODE: $146.2672265-P
CPT CODE: $721.3172270-5
CPT CODE: $233.1972270-P
CPT CODE: $219.9772275-5
CPT CODE: $66.3372275-P
CPT CODE: $484.1772285-5
CPT CODE: $112.6472285-P
CPT CODE: $484.1772295-5
CPT CODE: $130.4272295-P
CPT CODE: $81.0473000-5
CPT CODE: $39.5373000-P
CPT CODE: $98.8173010-5
CPT CODE: $45.4573010-P
CPT CODE: $81.0473020-5
CPT CODE: $39.5373020-P
Page 38
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $100.8073030-5
CPT CODE: $45.4573030-P
CPT CODE: $326.0773040-5
CPT CODE: $102.7673040-P
CPT CODE: $100.8073050-5
CPT CODE: $47.4473050-P
CPT CODE: $98.8173060-5
CPT CODE: $43.4773060-P
CPT CODE: $94.8673070-5
CPT CODE: $39.5373070-P
CPT CODE: $104.7373080-5
CPT CODE: $45.4573080-P
CPT CODE: $345.8473085-5
CPT CODE: $148.2073085-P
CPT CODE: $94.8673090-5
CPT CODE: $39.5373090-P
CPT CODE: $75.1173092-5
CPT CODE: $33.5973092-P
CPT CODE: $81.0473100-5
CPT CODE: $39.5373100-P
CPT CODE: $102.7673110-5
CPT CODE: $45.4573110-P
CPT CODE: $345.8473115-5
CPT CODE: $148.2073115-P
CPT CODE: $75.1173120-5
CPT CODE: $39.5373120-P
CPT CODE: $96.8473130-5
CPT CODE: $45.4573130-P
CPT CODE: $73.1073140-5
CPT CODE: $37.5473140-P
CPT CODE: $333.9873200-5
CPT CODE: $207.4873200-P
CPT CODE: $371.5373201-5
CPT CODE: $296.4373201-P
CPT CODE: $371.5373202-5
CPT CODE: $296.4373202-P
CPT CODE: $366.5473206-5
CPT CODE: $110.7473206-P
CPT CODE: $650.4173218-5
CPT CODE: $194.9773218-P
CPT CODE: $709.6973219-5
CPT CODE: $213.6973219-P
CPT CODE: $968.3473220-5
CPT CODE: $335.9573220-P
CPT CODE: $968.3473221-5
CPT CODE: $335.9573221-P
CPT CODE: $725.2873222-5
CPT CODE: $218.3673222-P
CPT CODE: $963.9073223-5
CPT CODE: $288.5573223-P
CPT CODE: $914.5373225-5
CPT CODE: $335.9573225-P
CPT CODE: $31.5973501-5
CPT CODE: $10.6973501-P
CPT CODE: $43.5773502-5
CPT CODE: $12.7373502-P
CPT CODE: $54.3973503-5
CPT CODE: $16.1673503-P
CPT CODE: $42.1073521-5
CPT CODE: $13.0973521-P
CPT CODE: $51.5473522-5
CPT CODE: $17.0073522-P
CPT CODE: $59.7373523-5
CPT CODE: $18.2073523-P
CPT CODE: $335.9573525-5
CPT CODE: $148.2073525-P
CPT CODE: $29.2973551-5
CPT CODE: $9.4873551-P
CPT CODE: $33.9573552-5
CPT CODE: $10.6973552-P
CPT CODE: $88.9373560-5
CPT CODE: $35.5973560-P
CPT CODE: $99.6173562-5
CPT CODE: $42.7073562-P
CPT CODE: $120.5373564-5
CPT CODE: $49.3973564-P
CPT CODE: $160.0773565-5
CPT CODE: $59.2873565-P
CPT CODE: $345.8473580-5
CPT CODE: $98.8173580-P
CPT CODE: $96.8473590-5
CPT CODE: $39.5373590-P
CPT CODE: $71.1673592-5
CPT CODE: $33.5973592-P
CPT CODE: $88.9173600-5
CPT CODE: $37.5473600-P
CPT CODE: $102.7673610-5
CPT CODE: $45.4573610-P
CPT CODE: $335.9573615-5
CPT CODE: $148.2073615-P
CPT CODE: $75.1173620-5
CPT CODE: $39.5373620-P
CPT CODE: $102.7673630-5
CPT CODE: $40.7473630-P
CPT CODE: $88.9173650-5
CPT CODE: $39.5373650-P
CPT CODE: $71.1673660-5
CPT CODE: $37.5473660-P
CPT CODE: $395.2673700-5
CPT CODE: $148.1573700-P
CPT CODE: $424.8873701-5
CPT CODE: $159.2873701-P
CPT CODE: $424.8873702-5
CPT CODE: $159.2873702-P
CPT CODE: $366.5473706-5
CPT CODE: $110.7473706-P
CPT CODE: $650.4173718-5
CPT CODE: $194.9773718-P
CPT CODE: $709.6973719-5
CPT CODE: $244.8973719-P
CPT CODE: $968.3473720-5
CPT CODE: $335.9573720-P
CPT CODE: $968.3473721-5
CPT CODE: $335.9573721-P
CPT CODE: $725.2873722-5
CPT CODE: $218.3673722-P
CPT CODE: $959.2473723-5
CPT CODE: $288.5573723-P
CPT CODE: $914.5373725-5
CPT CODE: $335.9573725-P
CPT CODE: $49.4574018-5
CPT CODE: $20.2374018-P
CPT CODE: $77.5574019-5
CPT CODE: $29.2274019-P
CPT CODE: $82.0474021-5
CPT CODE: $34.8474021-P
CPT CODE: $146.2674022-5
CPT CODE: $61.1174022-P
CPT CODE: $453.8974150-5
CPT CODE: $185.2074150-P
CPT CODE: $526.5574160-5
CPT CODE: $214.8274160-P
CPT CODE: $635.4574170-5
CPT CODE: $259.3174170-P
CPT CODE: $322.6874174-5
CPT CODE: $171.9874174-P
CPT CODE: $683.1674175-5
CPT CODE: $204.3374175-P
CPT CODE: $141.4274176-5
CPT CODE: $179.7474176-P
CPT CODE: $221.3574177-5
CPT CODE: $188.5474177-P
CPT CODE: $279.7574178-5
CPT CODE: $208.4274178-P
CPT CODE: $968.3474181-5
CPT CODE: $335.9574181-P
CPT CODE: $792.3374182-5
CPT CODE: $237.0874182-P
CPT CODE: $1,052.8274183-5
CPT CODE: $316.6374183-P
CPT CODE: $914.5374185-5
CPT CODE: $335.9574185-P
Page 39
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $128.8074190-5
CPT CODE: $57.8874190-P
CPT CODE: $179.8274210-5
CPT CODE: $67.1774210-P
CPT CODE: $163.9974220-5
CPT CODE: $71.1674220-P
CPT CODE: $107.8774221-5
CPT CODE: $36.5474221-P
CPT CODE: $71.3374221-TC
CPT CODE: $146.2674230-5
CPT CODE: $102.7674230-P
CPT CODE: $1,551.3474235-5
CPT CODE: $1,551.3474235-P
CPT CODE: $187.7374240-5
CPT CODE: $70.3974240-P
CPT CODE: $256.9274246-5
CPT CODE: $96.3274246-P
CPT CODE: $82.4174248-5
CPT CODE: $36.5474248-P
CPT CODE: $45.8774248-TC
CPT CODE: $175.8674250-5
CPT CODE: $75.1174250-P
CPT CODE: $175.4474251-5
CPT CODE: $74.6474251-P
CPT CODE: $241.2174261-5
CPT CODE: $192.9774261-P
CPT CODE: $270.8074262-5
CPT CODE: $212.2674262-P
CPT CODE: $241.2174263-5
CPT CODE: $192.9774263-P
CPT CODE: $187.7374270-5
CPT CODE: $70.3974270-P
CPT CODE: $237.1574280-5
CPT CODE: $88.8974280-P
CPT CODE: $251.0074283-5
CPT CODE: $104.7374283-P
CPT CODE: $160.0774290-5
CPT CODE: $63.2174290-P
CPT CODE: $239.1374300-5
CPT CODE: $65.2074300-P
CPT CODE: $116.6074301-5
CPT CODE: $37.5474301-P
CPT CODE: $395.2674328-5
CPT CODE: $126.4974328-P
CPT CODE: $424.8874329-5
CPT CODE: $165.9974329-P
CPT CODE: $235.1574330-5
CPT CODE: $126.4974330-P
CPT CODE: $464.3874340-5
CPT CODE: $126.4974340-P
CPT CODE: $335.9574355-5
CPT CODE: $120.5374355-P
CPT CODE: $142.2974360-5
CPT CODE: $98.8174360-P
CPT CODE: $326.0774363-5
CPT CODE: $98.8174363-P
CPT CODE: $254.9374400-5
CPT CODE: $100.8074400-P
CPT CODE: $245.0674410-5
CPT CODE: $102.7674410-P
CPT CODE: $316.2174415-5
CPT CODE: $116.6074415-P
CPT CODE: $163.9974420-5
CPT CODE: $63.2174420-P
CPT CODE: $203.5274425-5
CPT CODE: $81.0474425-P
CPT CODE: $185.7774430-5
CPT CODE: $61.2674430-P
CPT CODE: $203.5274440-5
CPT CODE: $73.1074440-P
CPT CODE: $203.5274445-5
CPT CODE: $104.7374445-P
CPT CODE: $195.6574450-5
CPT CODE: $61.2674450-P
CPT CODE: $203.5274455-5
CPT CODE: $98.8174455-P
CPT CODE: $173.8974470-5
CPT CODE: $73.1074470-P
CPT CODE: $830.0274485-5
CPT CODE: $345.8474485-P
CPT CODE: $156.1274710-5
CPT CODE: $63.2174710-P
CPT CODE: $225.5574712-5
CPT CODE: $170.4374712-P
CPT CODE: $123.3974713-5
CPT CODE: $100.9374713-P
CPT CODE: $245.0674740-5
CPT CODE: $65.2074740-P
CPT CODE: $216.2174742-5
CPT CODE: $170.2974742-P
CPT CODE: $345.8474775-5
CPT CODE: $112.6474775-P
CPT CODE: $293.6475557-5
CPT CODE: $137.1275557-P
CPT CODE: $425.5975559-5
CPT CODE: $173.3475559-P
CPT CODE: $394.5475561-5
CPT CODE: $151.3575561-P
CPT CODE: $487.6775563-5
CPT CODE: $181.1075563-P
CPT CODE: $434.8375565-5
CPT CODE: $110.6475565-P
CPT CODE: $62.3975571-5
CPT CODE: $50.8175571-P
CPT CODE: $358.2875572-5
CPT CODE: $248.2875572-P
CPT CODE: $358.2875573-5
CPT CODE: $312.6175573-P
CPT CODE: $419.3975574-5
CPT CODE: $330.6275574-P
CPT CODE: $681.8175600-5
CPT CODE: $243.0875600-P
CPT CODE: $948.6175605-5
CPT CODE: $272.7475605-P
CPT CODE: $948.6175625-5
CPT CODE: $179.8275625-P
CPT CODE: $899.1675630-5
CPT CODE: $306.3075630-P
CPT CODE: $717.4775635-5
CPT CODE: $215.2475635-P
CPT CODE: $711.4475705-5
CPT CODE: $294.4775705-P
CPT CODE: $484.1775710-5
CPT CODE: $134.3875710-P
CPT CODE: $721.3175716-5
CPT CODE: $185.7775716-P
CPT CODE: $1,077.0375726-5
CPT CODE: $205.5275726-P
CPT CODE: $948.6175731-5
CPT CODE: $249.0175731-P
CPT CODE: $1,077.0375733-5
CPT CODE: $355.7575733-P
CPT CODE: $721.3175736-5
CPT CODE: $229.2675736-P
CPT CODE: $721.3175741-5
CPT CODE: $229.2675741-P
CPT CODE: $839.9175743-5
CPT CODE: $760.8375743-P
CPT CODE: $721.3175746-5
CPT CODE: $229.2675746-P
CPT CODE: $721.3175756-5
CPT CODE: $136.3775756-P
CPT CODE: $444.6575774-5
CPT CODE: $167.9975774-P
CPT CODE: $592.8775801-5
CPT CODE: $136.3775801-P
CPT CODE: $721.3175803-5
CPT CODE: $229.2675803-P
CPT CODE: $592.8775805-5
CPT CODE: $179.8275805-P
CPT CODE: $721.3175807-5
CPT CODE: $249.0175807-P
Page 40
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $256.3575809-5
CPT CODE: $147.3275809-P
CPT CODE: $592.8775810-5
CPT CODE: $136.3775810-P
CPT CODE: $345.8475820-5
CPT CODE: $94.8675820-P
CPT CODE: $484.1775822-5
CPT CODE: $152.1675822-P
CPT CODE: $484.1775825-5
CPT CODE: $128.4475825-P
CPT CODE: $484.1775827-5
CPT CODE: $136.3775827-P
CPT CODE: $523.7075831-5
CPT CODE: $160.0775831-P
CPT CODE: $592.8775833-5
CPT CODE: $316.2175833-P
CPT CODE: $523.7075840-5
CPT CODE: $205.5275840-P
CPT CODE: $592.8775842-5
CPT CODE: $316.2175842-P
CPT CODE: $721.3175860-5
CPT CODE: $294.4775860-P
CPT CODE: $592.8775870-5
CPT CODE: $229.2675870-P
CPT CODE: $1,067.1575872-5
CPT CODE: $464.3875872-P
CPT CODE: $484.1775880-5
CPT CODE: $136.3775880-P
CPT CODE: $1,077.0375885-5
CPT CODE: $335.9575885-P
CPT CODE: $1,077.0375887-5
CPT CODE: $335.9575887-P
CPT CODE: $1,077.0375889-5
CPT CODE: $335.9575889-P
CPT CODE: $1,077.0375891-5
CPT CODE: $335.9575891-P
CPT CODE: $1,818.1575893-5
CPT CODE: $523.7075893-P
CPT CODE: $652.1975894-5
CPT CODE: $272.7475894-P
CPT CODE: $1,037.5075898-5
CPT CODE: $375.4675898-P
CPT CODE: $409.0075901-5
CPT CODE: $115.7775901-P
CPT CODE: $409.0075902-5
CPT CODE: $115.7775902-P
CPT CODE: $355.7575970-5
CPT CODE: $154.1575970-P
CPT CODE: $316.2175984-5
CPT CODE: $229.2675984-P
CPT CODE: $355.7575989-5
CPT CODE: $152.1675989-P
CPT CODE: $96.8476000-5
CPT CODE: $79.0276000-P
CPT CODE: $223.3176010-5
CPT CODE: $112.6476010-P
CPT CODE: $81.0476080-5
CPT CODE: $61.2676080-P
CPT CODE: $69.1576098-5
CPT CODE: $21.7676098-P
CPT CODE: $235.1576100-5
CPT CODE: $106.7276100-P
CPT CODE: $284.5876101-5
CPT CODE: $175.8676101-P
CPT CODE: $375.4676102-5
CPT CODE: $156.1276102-P
CPT CODE: $264.7976120-5
CPT CODE: $98.8176120-P
CPT CODE: $61.2676125-5
CPT CODE: $31.6276125-P
CPT CODE: $108.6976140-5
CPT CODE: $108.6976140-P
CPT CODE: $173.5776376-5
CPT CODE: $15.1676376-P
CPT CODE: $223.1676377-5
CPT CODE: $56.4976377-P
CPT CODE: $160.0776380-5
CPT CODE: $59.2876380-P
CPT CODE: $405.1176506-5
CPT CODE: $264.7976506-P
CPT CODE: $305.1576510-5
CPT CODE: $161.8876510-P
CPT CODE: $326.0776511-5
CPT CODE: $136.3776511-P
CPT CODE: $245.0676512-5
CPT CODE: $101.8576512-P
CPT CODE: $355.7576513-5
CPT CODE: $148.1576513-P
CPT CODE: $242.0076514-5
CPT CODE: $159.3776514-P
CPT CODE: $316.2176516-5
CPT CODE: $146.2676516-P
CPT CODE: $245.0676519-5
CPT CODE: $128.4476519-P
CPT CODE: $326.0776529-5
CPT CODE: $142.2976529-P
CPT CODE: $223.3176536-5
CPT CODE: $104.7376536-P
CPT CODE: $444.6576604-5
CPT CODE: $128.4476604-P
CPT CODE: $120.0876641-5
CPT CODE: $39.8776641-P
CPT CODE: $98.9576642-5
CPT CODE: $37.1076642-P
CPT CODE: $237.1576700-5
CPT CODE: $88.8976700-P
CPT CODE: $177.8476705-5
CPT CODE: $66.6976705-P
CPT CODE: $143.5876706-5
CPT CODE: $47.6776706-P
CPT CODE: $335.9576770-5
CPT CODE: $169.9676770-P
CPT CODE: $282.6076775-5
CPT CODE: $126.4976775-P
CPT CODE: $249.6076776-5
CPT CODE: $111.9976776-P
CPT CODE: $326.0776800-5
CPT CODE: $148.2076800-P
CPT CODE: $112.7876801-5
CPT CODE: $45.1076801-P
CPT CODE: $84.2076802-5
CPT CODE: $34.5976802-P
CPT CODE: $197.6476805-5
CPT CODE: $74.0776805-P
CPT CODE: $203.5276810-5
CPT CODE: $148.2076810-P
CPT CODE: $330.8076811-5
CPT CODE: $174.4376811-P
CPT CODE: $198.4876812-5
CPT CODE: $105.2676812-P
CPT CODE: $101.2076813-5
CPT CODE: $40.4876813-P
CPT CODE: $75.5676814-5
CPT CODE: $31.0376814-P
CPT CODE: $148.2076815-5
CPT CODE: $55.5876815-P
CPT CODE: $106.7276816-5
CPT CODE: $40.7476816-P
CPT CODE: $127.8176817-5
CPT CODE: $51.1376817-P
CPT CODE: $239.1376818-5
CPT CODE: $142.2976818-P
CPT CODE: $116.9876819-5
CPT CODE: $46.8076819-P
CPT CODE: $110.3276820-5
CPT CODE: $34.3876820-P
CPT CODE: $121.7876821-5
CPT CODE: $47.2776821-P
CPT CODE: $395.2676825-5
CPT CODE: $205.5276825-P
CPT CODE: $296.5476826-5
CPT CODE: $80.3776826-P
Page 41
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $267.8376827-5
CPT CODE: $70.7876827-P
CPT CODE: $296.5476828-5
CPT CODE: $80.3776828-P
CPT CODE: $217.4176830-5
CPT CODE: $169.9676830-P
CPT CODE: $246.6576831-5
CPT CODE: $97.9876831-P
CPT CODE: $270.4276856-5
CPT CODE: $106.7276856-P
CPT CODE: $166.6876857-5
CPT CODE: $45.4576857-P
CPT CODE: $335.9576870-5
CPT CODE: $128.4476870-P
CPT CODE: $500.0676872-5
CPT CODE: $169.9676872-P
CPT CODE: $436.7176873-5
CPT CODE: $155.2776873-P
CPT CODE: $194.6476881-5
CPT CODE: $82.1676881-P
CPT CODE: $50.4176882-5
CPT CODE: $33.7476882-P
CPT CODE: $260.1576885-5
CPT CODE: $113.1876885-P
CPT CODE: $260.1676886-5
CPT CODE: $113.1876886-P
CPT CODE: $484.1776932-5
CPT CODE: $258.8976932-P
CPT CODE: $113.6276937-5
CPT CODE: $41.3176937-P
CPT CODE: $265.6176940-5
CPT CODE: $106.2476940-P
CPT CODE: $212.4476941-5
CPT CODE: $118.0276941-P
CPT CODE: $292.4976942-5
CPT CODE: $128.4476942-P
CPT CODE: $435.7576945-5
CPT CODE: $197.9076945-P
CPT CODE: $213.4276946-5
CPT CODE: $116.6076946-P
CPT CODE: $444.6576948-5
CPT CODE: $197.6476948-P
CPT CODE: $344.7376965-5
CPT CODE: $114.9376965-P
CPT CODE: $185.7776970-5
CPT CODE: $63.2176970-P
CPT CODE: $169.8776975-P
CPT CODE: $340.5376977-5
CPT CODE: $111.3076977-P
CPT CODE: $325.1676998-5
CPT CODE: $148.4276998-P
CPT CODE: $98.4977001-5
CPT CODE: $36.4377001-P
CPT CODE: $98.4977002-5
CPT CODE: $36.4377002-P
CPT CODE: $101.2077003-5
CPT CODE: $39.1377003-P
CPT CODE: $484.3777011-5
CPT CODE: $148.4277011-P
CPT CODE: $510.0077012-5
CPT CODE: $152.4677012-P
CPT CODE: $466.8377013-5
CPT CODE: $205.0877013-P
CPT CODE: $145.7277014-5
CPT CODE: $132.2277014-P
CPT CODE: $827.0677021-5
CPT CODE: $223.9777021-P
CPT CODE: $1,033.5077022-5
CPT CODE: $310.3277022-P
CPT CODE: $126.2677046-5
CPT CODE: $77.7277046-P
CPT CODE: $87.4177046-TC
CPT CODE: $129.8777047-5
CPT CODE: $85.9777047-P
CPT CODE: $86.8877047-TC
CPT CODE: $200.1377048-5
CPT CODE: $112.3877048-P
CPT CODE: $143.9477048-TC
CPT CODE: $204.7177049-5
CPT CODE: $122.9777049-P
CPT CODE: $143.2377049-TC
CPT CODE: $152.0677053-5
CPT CODE: $66.1177053-P
CPT CODE: $208.1877054-5
CPT CODE: $66.1177054-P
CPT CODE: $49.7777061-5
CPT CODE: $27.6977061-P
CPT CODE: $61.4477062-5
CPT CODE: $34.6277062-P
CPT CODE: $63.4977063-5
CPT CODE: $33.2777063-P
CPT CODE: $143.5877065-5
CPT CODE: $45.8377065-P
CPT CODE: $173.4577066-5
CPT CODE: $56.1777066-P
CPT CODE: $164.2577067-5
CPT CODE: $45.8377067-P
CPT CODE: $83.6577072-5
CPT CODE: $48.5777072-P
CPT CODE: $83.6577073-5
CPT CODE: $47.2277073-P
CPT CODE: $148.4277074-5
CPT CODE: $85.0077074-P
CPT CODE: $269.8477075-5
CPT CODE: $99.8477075-P
CPT CODE: $85.0077076-5
CPT CODE: $40.4877076-P
CPT CODE: $76.9177077-5
CPT CODE: $44.5277077-P
CPT CODE: $87.7077078-5
CPT CODE: $68.8177078-P
CPT CODE: $174.0477080-5
CPT CODE: $40.4877080-P
CPT CODE: $87.7077081-5
CPT CODE: $26.9977081-P
CPT CODE: $429.0577084-5
CPT CODE: $290.0877084-P
CPT CODE: $103.3577085-5
CPT CODE: $27.7677085-P
CPT CODE: $41.8177086-5
CPT CODE: $9.7277086-P
CPT CODE: $513.8377261-E
CPT CODE: $513.8377261-P
CPT CODE: $652.1977262-E
CPT CODE: $652.1977262-P
CPT CODE: $780.6077263-E
CPT CODE: $780.6077263-P
CPT CODE: $642.2777280-E
CPT CODE: $195.6577280-P
CPT CODE: $770.7377285-E
CPT CODE: $225.2777285-P
CPT CODE: $810.2677290-E
CPT CODE: $280.6377290-P
CPT CODE: $455.3577293-5
CPT CODE: $114.4977293-P
CPT CODE: $802.5477295-E
CPT CODE: $280.0077295-P
CPT CODE: $294.4777300-E
CPT CODE: $187.7377300-P
CPT CODE: $2,476.1277301-E
CPT CODE: $265.3677301-P
CPT CODE: $169.5577306-5
CPT CODE: $86.4277306-P
CPT CODE: $356.5277307-5
CPT CODE: $191.2177307-P
CPT CODE: $206.4577316-5
CPT CODE: $77.7577316-P
CPT CODE: $270.2377317-5
CPT CODE: $102.1777317-P
CPT CODE: $390.9777318-5
CPT CODE: $161.2477318-P
CPT CODE: $642.2777321-E
Page 42
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $258.8977321-P
CPT CODE: $464.3877331-E
CPT CODE: $199.5977331-P
CPT CODE: $474.2777332-E
CPT CODE: $187.7377332-P
CPT CODE: $533.5977333-E
CPT CODE: $254.9377333-P
CPT CODE: $711.4477334-E
CPT CODE: $326.0777334-P
CPT CODE: $464.3877336-E
CPT CODE: $326.0777336-P
CPT CODE: $774.4577338-E
CPT CODE: $365.3577338-P
CPT CODE: $444.6577370-E
CPT CODE: $268.7777370-P
CPT CODE: $1,380.2377371-E
CPT CODE: $1,048.3377372-E
CPT CODE: $219.3477401-E
CPT CODE: $219.3477402-E
CPT CODE: $296.4377407-E
CPT CODE: $355.7577412-E
CPT CODE: $73.1077417-E
CPT CODE: $41.4877417-P
CPT CODE: $234.1977423-E
CPT CODE: $97.0577427-E
CPT CODE: $97.0577427-P
CPT CODE: $142.6177430-E
CPT CODE: $92.6177431-E
CPT CODE: $92.6177431-P
CPT CODE: $5,748.6377432-E
CPT CODE: $5,748.6377432-P
CPT CODE: $331.3077469-E
CPT CODE: $731.2177470-E
CPT CODE: $294.4777470-P
CPT CODE: $200.5677520-E
CPT CODE: $227.7277522-E
CPT CODE: $273.3677523-E
CPT CODE: $297.9277525-E
CPT CODE: $375.4677600-P
CPT CODE: $978.2377750-E
CPT CODE: $1,017.7577750-P
CPT CODE: $1,837.8977761-E
CPT CODE: $1,225.2477761-P
CPT CODE: $2,144.2277762-E
CPT CODE: $1,452.5077762-P
CPT CODE: $2,351.7277763-E
CPT CODE: $1,620.4977763-P
CPT CODE: $237.7877767-E
CPT CODE: $61.1877767-P
CPT CODE: $371.4377768-E
CPT CODE: $81.1577768-P
CPT CODE: $341.4977770-E
CPT CODE: $113.0377770-P
CPT CODE: $636.9077771-E
CPT CODE: $220.7877771-P
CPT CODE: $969.7277772-E
CPT CODE: $313.0977772-P
CPT CODE: $3,063.1677778-E
CPT CODE: $2,084.8877778-P
CPT CODE: $88.9177789-E
CPT CODE: $88.9177789-P
CPT CODE: $434.7677790-E
CPT CODE: $345.8477790-P
CPT CODE: $87.0878012-5
CPT CODE: $15.4578012-P
CPT CODE: $219.6478013-5
CPT CODE: $30.0178013-P
CPT CODE: $254.5478014-5
CPT CODE: $40.0078014-P
CPT CODE: $375.4678015-5
CPT CODE: $142.2978015-P
CPT CODE: $424.8878016-5
CPT CODE: $152.1678016-P
CPT CODE: $503.9578018-5
CPT CODE: $203.5278018-P
CPT CODE: $94.6978020-5
CPT CODE: $58.1578020-P
CPT CODE: $484.1778070-5
CPT CODE: $156.1278070-P
CPT CODE: $381.3778071-5
CPT CODE: $95.2678071-P
CPT CODE: $97.0378072-P
CPT CODE: $513.8378075-5
CPT CODE: $203.5278075-P
CPT CODE: $582.9878102-5
CPT CODE: $225.2778102-P
CPT CODE: $622.5078103-5
CPT CODE: $171.9378103-P
CPT CODE: $721.3178104-5
CPT CODE: $163.9978104-P
CPT CODE: $116.6078110-5
CPT CODE: $55.3278110-P
CPT CODE: $280.6378111-5
CPT CODE: $73.1078111-P
CPT CODE: $239.1378120-5
CPT CODE: $108.6978120-P
CPT CODE: $345.8478121-5
CPT CODE: $156.1278121-P
CPT CODE: $294.4778122-5
CPT CODE: $112.6478122-P
CPT CODE: $484.1778130-5
CPT CODE: $146.2678130-P
CPT CODE: $484.1778135-5
CPT CODE: $171.9378135-P
CPT CODE: $484.1778140-5
CPT CODE: $156.1278140-P
CPT CODE: $592.8778185-5
CPT CODE: $124.5078185-P
CPT CODE: $523.7078191-5
CPT CODE: $152.1678191-P
CPT CODE: $523.7078195-5
CPT CODE: $116.6078195-P
CPT CODE: $484.1778201-5
CPT CODE: $130.4278201-P
CPT CODE: $760.8378202-5
CPT CODE: $112.6478202-P
CPT CODE: $563.1978215-5
CPT CODE: $160.0778215-P
CPT CODE: $1,254.9178216-5
CPT CODE: $148.2078216-P
CPT CODE: $350.6378226-5
CPT CODE: $59.3278226-P
CPT CODE: $476.9078227-5
CPT CODE: $71.6878227-P
CPT CODE: $278.6178230-5
CPT CODE: $110.6778230-P
CPT CODE: $345.8478231-5
CPT CODE: $110.6778231-P
CPT CODE: $395.2678232-5
CPT CODE: $156.1278232-P
CPT CODE: $199.5978258-5
CPT CODE: $81.0478258-P
CPT CODE: $523.7078261-5
CPT CODE: $223.3178261-P
CPT CODE: $365.5878262-5
CPT CODE: $100.8078262-P
CPT CODE: $395.2678264-5
CPT CODE: $167.9978264-P
CPT CODE: $395.3678265-E
CPT CODE: $54.5878265-P
CPT CODE: $511.1078266-E
CPT CODE: $60.4778266-P
CPT CODE: $258.7978267-5
CPT CODE: $77.6578267-P
CPT CODE: $37.2278268-5
CPT CODE: $11.1678268-P
CPT CODE: $523.7078278-5
CPT CODE: $177.8478278-P
CPT CODE: $316.2178282-5
CPT CODE: $84.9678282-P
CPT CODE: $582.9878290-5
CPT CODE: $116.6078290-P
Page 43
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $592.8778291-5
CPT CODE: $156.1278291-P
CPT CODE: $582.9878300-5
CPT CODE: $162.0378300-P
CPT CODE: $711.4478305-5
CPT CODE: $221.3378305-P
CPT CODE: $691.6978306-5
CPT CODE: $165.9978306-P
CPT CODE: $375.4678315-5
CPT CODE: $144.2778315-P
CPT CODE: $365.5878350-5
CPT CODE: $116.6078350-P
CPT CODE: $365.5878351-5
CPT CODE: $116.6078351-P
CPT CODE: $523.7078414-5
CPT CODE: $207.4878414-P
CPT CODE: $484.1778428-5
CPT CODE: $254.9378428-P
CPT CODE: $931.5078429-5
CPT CODE: $136.4978429-P
CPT CODE: $863.2678429-TC
CPT CODE: $520.2178430-5
CPT CODE: $108.6478430-P
CPT CODE: $465.8978430-TC
CPT CODE: $841.7478431-5
CPT CODE: $135.2778431-P
CPT CODE: $774.1178431-TC
CPT CODE: $1,060.1878432-5
CPT CODE: $140.4178432-P
CPT CODE: $989.9778432-TC
CPT CODE: $1,147.8078433-5
CPT CODE: $174.0178433-P
CPT CODE: $1,060.7978433-TC
CPT CODE: $53.7578434-5
CPT CODE: $32.5578434-P
CPT CODE: $37.4778434-TC
CPT CODE: $355.7578445-5
CPT CODE: $175.8678445-P
CPT CODE: $755.1578451-5
CPT CODE: $194.2678451-P
CPT CODE: $1,125.6678452-5
CPT CODE: $442.5478452-P
CPT CODE: $522.3078453-5
CPT CODE: $141.5178453-P
CPT CODE: $508.1578454-5
CPT CODE: $187.8278454-P
CPT CODE: $431.8678456-5
CPT CODE: $163.3778456-P
CPT CODE: $474.2778457-5
CPT CODE: $177.8478457-P
CPT CODE: $494.0578458-5
CPT CODE: $177.8478458-P
CPT CODE: $652.1978466-5
CPT CODE: $187.7378466-P
CPT CODE: $652.1978468-5
CPT CODE: $187.7378468-P
CPT CODE: $652.1978469-5
CPT CODE: $187.7378469-P
CPT CODE: $573.0878472-5
CPT CODE: $193.6678472-P
CPT CODE: $909.0478473-5
CPT CODE: $365.5878473-P
CPT CODE: $928.8278481-5
CPT CODE: $243.0878481-P
CPT CODE: $1,363.6078483-5
CPT CODE: $395.2678483-P
CPT CODE: $544.8478494-5
CPT CODE: $182.7178494-P
CPT CODE: $468.4478496-5
CPT CODE: $182.7178496-P
CPT CODE: $205.2378579-5
CPT CODE: $28.6678579-P
CPT CODE: $513.8378580-5
CPT CODE: $142.2978580-P
CPT CODE: $379.0378582-5
CPT CODE: $62.2878582-P
CPT CODE: $232.4278597-5
CPT CODE: $43.1278597-P
CPT CODE: $355.7678598-5
CPT CODE: $48.9478598-P
CPT CODE: $563.1978600-5
CPT CODE: $165.9978600-P
CPT CODE: $721.3178601-5
CPT CODE: $205.5278601-P
CPT CODE: $780.6078605-5
CPT CODE: $160.0778605-P
CPT CODE: $909.0478606-5
CPT CODE: $171.9378606-P
CPT CODE: $395.2678610-5
CPT CODE: $73.1078610-P
CPT CODE: $721.3178630-5
CPT CODE: $112.6478630-P
CPT CODE: $355.7578635-5
CPT CODE: $171.9378635-P
CPT CODE: $405.1178645-5
CPT CODE: $156.1278645-P
CPT CODE: $484.1778650-5
CPT CODE: $171.9378650-P
CPT CODE: $278.6178660-5
CPT CODE: $405.1178700-5
CPT CODE: $116.6078700-P
CPT CODE: $642.2778701-5
CPT CODE: $148.2078701-P
CPT CODE: $770.7378707-5
CPT CODE: $175.8678707-P
CPT CODE: $451.0578708-5
CPT CODE: $201.0278708-P
CPT CODE: $758.5178709-5
CPT CODE: $174.0078709-P
CPT CODE: $316.2178725-5
CPT CODE: $160.0778725-P
CPT CODE: $102.7678730-5
CPT CODE: $33.5978730-P
CPT CODE: $294.4778740-5
CPT CODE: $96.8478740-P
CPT CODE: $909.0478761-5
CPT CODE: $223.3178761-P
CPT CODE: $395.2678800-5
CPT CODE: $185.7778800-P
CPT CODE: $592.8778801-5
CPT CODE: $185.7778801-P
CPT CODE: $810.2678802-5
CPT CODE: $185.7778802-P
CPT CODE: $405.1178803-5
CPT CODE: $116.6078803-P
CPT CODE: $996.0478804-E
CPT CODE: $98.8678804-P
CPT CODE: $75.4278808-5
CPT CODE: $75.4278808-P
CPT CODE: $1,687.6478811-5
CPT CODE: $336.6778811-P
CPT CODE: $1,687.6478812-5
CPT CODE: $336.6778812-P
CPT CODE: $1,687.6478813-5
CPT CODE: $336.6778813-P
CPT CODE: $1,901.1178814-5
CPT CODE: $348.1378814-P
CPT CODE: $1,901.1178815-5
CPT CODE: $348.1378815-P
CPT CODE: $1,901.1178816-5
CPT CODE: $348.1378816-P
CPT CODE: $490.0578830-5
CPT CODE: $75.4978830-P
CPT CODE: $414.5678830-TC
CPT CODE: $707.4578831-5
CPT CODE: $92.1078831-P
CPT CODE: $615.3578831-TC
CPT CODE: $919.9278832-5
CPT CODE: $107.2978832-P
CPT CODE: $812.6478832-TC
CPT CODE: $103.2978835-5
CPT CODE: $23.6878835-P
Page 44
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $79.6078835-TC
CPT CODE: $660.4579005-E
CPT CODE: $448.4179005-P
CPT CODE: $448.4179101-E
CPT CODE: $179.0879101-P
CPT CODE: $996.0479403-E
CPT CODE: $236.1179403-P
CPT CODE: $441.2579445-E
CPT CODE: $266.4779445-P
CPT CODE: $34.0280047-8
CPT CODE: $12.0280047-P
CPT CODE: $11.6580048-8
CPT CODE: $4.1280048-P
CPT CODE: $41.6880050-8
CPT CODE: $12.6680051-8
CPT CODE: $15.5380053-8
CPT CODE: $5.4780053-P
CPT CODE: $51.9080055-8
CPT CODE: $22.2380061-8
CPT CODE: $12.4780069-8
CPT CODE: $4.3780069-P
CPT CODE: $46.9180074-8
CPT CODE: $14.0780074-P
CPT CODE: $11.3280076-8
CPT CODE: $4.3780076-P
CPT CODE: $88.8280081-8
CPT CODE: $36.0780150-8
CPT CODE: $17.7080155-8
CPT CODE: $51.6780156-8
CPT CODE: $19.6580157-8
CPT CODE: $6.9480157-P
CPT CODE: $57.4180158-8
CPT CODE: $13.5680159-8
CPT CODE: $47.8480162-8
CPT CODE: $15.7380163-8
CPT CODE: $47.8480164-8
CPT CODE: $16.0680165-8
CPT CODE: $51.6780168-8
CPT CODE: $18.0580169-8
CPT CODE: $34.4480170-8
CPT CODE: $14.8680171-8
CPT CODE: $35.8880173-8
CPT CODE: $12.6380173-P
CPT CODE: $14.8680175-8
CPT CODE: $28.7180176-8
CPT CODE: $14.8680177-8
CPT CODE: $16.0880178-8
CPT CODE: $30.0880180-8
CPT CODE: $14.8680183-8
CPT CODE: $31.5780184-8
CPT CODE: $37.7880185-8
CPT CODE: $47.8480186-8
CPT CODE: $31.5780188-8
CPT CODE: $40.2780190-8
CPT CODE: $57.4180192-8
CPT CODE: $29.5080194-8
CPT CODE: $21.0880195-8
CPT CODE: $7.4580195-P
CPT CODE: $30.8980197-8
CPT CODE: $33.8880198-8
CPT CODE: $29.0280199-8
CPT CODE: $53.3580200-8
CPT CODE: $47.8480202-8
CPT CODE: $14.8680203-8
CPT CODE: $68.1180299-8
CPT CODE: $12.8180305-8
CPT CODE: $17.0780306-8
CPT CODE: $68.2880307-8
CPT CODE: $91.4880400-8
CPT CODE: $244.5180402-8
CPT CODE: $244.5180406-8
CPT CODE: $438.6180408-8
CPT CODE: $401.2980410-8
CPT CODE: $1,129.2180412-8
CPT CODE: $192.2580414-8
CPT CODE: $184.7780415-8
CPT CODE: $403.0680416-8
CPT CODE: $134.3680417-8
CPT CODE: $2,221.0780418-8
CPT CODE: $216.4980420-8
CPT CODE: $188.5180422-8
CPT CODE: $201.5780424-8
CPT CODE: $615.9280426-8
CPT CODE: $298.6280428-8
CPT CODE: $345.2980430-8
CPT CODE: $270.6680432-8
CPT CODE: $307.9680434-8
CPT CODE: $447.9580435-8
CPT CODE: $266.9080436-8
CPT CODE: $145.5980438-8
CPT CODE: $194.0980439-8
CPT CODE: $61.0880500-8
CPT CODE: $61.2680500-P
CPT CODE: $103.7080502-8
CPT CODE: $98.8180502-P
CPT CODE: $12.7481000-8
CPT CODE: $11.4081001-8
CPT CODE: $10.3981002-8
CPT CODE: $10.0581003-8
CPT CODE: $13.8181005-8
CPT CODE: $9.8881007-8
CPT CODE: $10.5081015-8
CPT CODE: $19.9881020-8
CPT CODE: $18.1881025-8
CPT CODE: $9.5481050-8
CPT CODE: $141.3481105-8
CPT CODE: $141.3481106-8
CPT CODE: $141.3481107-8
CPT CODE: $141.3481108-8
CPT CODE: $141.3481109-8
CPT CODE: $141.3481110-8
CPT CODE: $141.3481111-8
CPT CODE: $141.3481112-8
CPT CODE: $167.3881120-8
CPT CODE: $251.0981121-8
CPT CODE: $2,165.0981162-8
CPT CODE: $1,322.4281163-8
CPT CODE: $786.3181164-8
CPT CODE: $464.6481165-8
CPT CODE: $321.6781166-8
CPT CODE: $464.6481167-8
CPT CODE: $106.1781170-8
CPT CODE: $100.0881171-8
CPT CODE: $218.0281172-8
CPT CODE: $321.6781173-8
CPT CODE: $167.9981174-8
CPT CODE: $279.7181176-8
CPT CODE: $100.0881177-8
CPT CODE: $100.0881178-8
CPT CODE: $100.0881179-8
CPT CODE: $100.0881180-8
CPT CODE: $100.0881181-8
CPT CODE: $100.0881182-8
CPT CODE: $100.0881183-8
CPT CODE: $100.0881184-8
CPT CODE: $251.1481185-8
CPT CODE: $167.9981186-8
CPT CODE: $100.0881187-8
CPT CODE: $100.0881188-8
CPT CODE: $218.0281189-8
CPT CODE: $167.9581190-8
CPT CODE: $106.1781219-8
CPT CODE: $148.3881230-8
CPT CODE: $148.3881231-8
CPT CODE: $148.3881232-8
CPT CODE: $127.8181233-8
CPT CODE: $100.0881234-8
CPT CODE: $464.6481236-8
CPT CODE: $127.8181237-8
CPT CODE: $218.0281239-8
CPT CODE: $148.3881247-8
CPT CODE: $79.0381248-8
Page 45
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $79.0381258-8
CPT CODE: $100.0881271-8
CPT CODE: $218.0281274-8
CPT CODE: $171.7481276-8
CPT CODE: $2,220.6081277-8
CPT CODE: $70.6681283-8
CPT CODE: $100.0881284-8
CPT CODE: $218.0281285-8
CPT CODE: $218.0281286-8
CPT CODE: $167.9981289-8
CPT CODE: $127.8181305-8
CPT CODE: $208.0781306-8
CPT CODE: $497.8681307-8
CPT CODE: $344.6881308-8
CPT CODE: $233.6281309-8
CPT CODE: $100.0881312-8
CPT CODE: $208.0781320-8
CPT CODE: $71.5881327-8
CPT CODE: $148.3881328-8
CPT CODE: $100.0881329-8
CPT CODE: $100.0881333-8
CPT CODE: $279.7181334-8
CPT CODE: $148.3881335-8
CPT CODE: $321.6781336-8
CPT CODE: $167.9581337-8
CPT CODE: $100.0881343-8
CPT CODE: $100.0881344-8
CPT CODE: $167.9981345-8
CPT CODE: $148.3881346-8
CPT CODE: $148.3881361-8
CPT CODE: $79.0381362-8
CPT CODE: $686.3881413-8
CPT CODE: $686.3881414-8
CPT CODE: $686.3881422-8
CPT CODE: $686.3881439-8
CPT CODE: $427.4081443-8
CPT CODE: $676.3281448-8
CPT CODE: $103.9381479-8
CPT CODE: $4,249.3481518-8
CPT CODE: $4,378.0381519-8
CPT CODE: $2,902.5581520-8
CPT CODE: $2,902.5581521-8
CPT CODE: $4,553.2181522-8
CPT CODE: $334.5181528-8
CPT CODE: $515.0981539-8
CPT CODE: $2,902.5581541-8
CPT CODE: $4,553.2181542-8
CPT CODE: $431.9481551-8
CPT CODE: $4,553.2181552-8
CPT CODE: $57.6381596-8
CPT CODE: $9.8882009-8
CPT CODE: $33.5982010-8
CPT CODE: $65.0982013-8
CPT CODE: $36.1282016-8
CPT CODE: $54.7482017-8
CPT CODE: $146.2682024-8
CPT CODE: $96.8482030-8
CPT CODE: $12.2282040-8
CPT CODE: $8.9182042-8
CPT CODE: $17.2382043-8
CPT CODE: $8.6282044-8
CPT CODE: $81.6782045-8
CPT CODE: $28.8082045-P
CPT CODE: $61.2682075-8
CPT CODE: $24.5282085-8
CPT CODE: $146.6982088-8
CPT CODE: $51.6782103-8
CPT CODE: $51.6782104-8
CPT CODE: $51.3582105-8
CPT CODE: $51.3582106-8
CPT CODE: $109.0282107-8
CPT CODE: $38.4582107-P
CPT CODE: $62.1482108-8
CPT CODE: $27.5182120-8
CPT CODE: $9.7082120-P
CPT CODE: $30.9882127-8
CPT CODE: $36.8682128-8
CPT CODE: $196.3082131-8
CPT CODE: $49.6182135-8
CPT CODE: $170.4482136-8
CPT CODE: $170.4482139-8
CPT CODE: $35.5682140-8
CPT CODE: $35.5682143-8
CPT CODE: $17.1982150-8
CPT CODE: $104.5482154-8
CPT CODE: $108.6982157-8
CPT CODE: $84.9682160-8
CPT CODE: $73.1082163-8
CPT CODE: $41.6182164-8
CPT CODE: $49.8082172-8
CPT CODE: $68.8882175-8
CPT CODE: $35.5682180-8
CPT CODE: $28.7182190-8
CPT CODE: $55.5882232-8
CPT CODE: $57.4182239-8
CPT CODE: $71.1682240-8
CPT CODE: $11.1182247-8
CPT CODE: $11.1182248-8
CPT CODE: $13.8182252-8
CPT CODE: $48.1782261-8
CPT CODE: $9.6982270-8
CPT CODE: $7.7182271-8
CPT CODE: $2.7282271-P
CPT CODE: $5.7982272-8
CPT CODE: $2.0382272-P
CPT CODE: $6.4982274-8
CPT CODE: $2.2782274-P
CPT CODE: $73.1082286-8
CPT CODE: $73.9982300-8
CPT CODE: $112.0482306-8
CPT CODE: $102.7682308-8
CPT CODE: $15.1082310-8
CPT CODE: $44.8682330-8
CPT CODE: $25.6882331-8
CPT CODE: $12.4382340-8
CPT CODE: $24.5282355-8
CPT CODE: $26.6982360-8
CPT CODE: $29.6482365-8
CPT CODE: $25.6182370-8
CPT CODE: $9.8382373-8
CPT CODE: $3.4782373-P
CPT CODE: $13.8182374-8
CPT CODE: $27.1782375-8
CPT CODE: $13.8182376-8
CPT CODE: $56.1582378-8
CPT CODE: $54.7482379-8
CPT CODE: $35.1482380-8
CPT CODE: $51.1782382-8
CPT CODE: $90.9182383-8
CPT CODE: $103.3782384-8
CPT CODE: $76.5482387-8
CPT CODE: $24.5282390-8
CPT CODE: $19.0682397-8
CPT CODE: $55.1482415-8
CPT CODE: $8.7982435-8
CPT CODE: $8.7982436-8
CPT CODE: $9.5482438-8
CPT CODE: $19.5582441-8
CPT CODE: $11.8782465-8
CPT CODE: $25.6182480-8
CPT CODE: $37.5482482-8
CPT CODE: $39.9282485-8
CPT CODE: $46.9482495-8
CPT CODE: $77.3982507-8
CPT CODE: $12.0382523-8
CPT CODE: $37.5482525-8
CPT CODE: $86.9682528-8
CPT CODE: $51.6782530-8
CPT CODE: $45.0282533-8
CPT CODE: $18.5382540-8
CPT CODE: $48.0282542-8
CPT CODE: $17.7082550-8
Page 46
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $52.0682552-8
CPT CODE: $50.4382553-8
CPT CODE: $50.4382554-8
CPT CODE: $12.3682565-8
CPT CODE: $9.9882570-8
CPT CODE: $24.8982575-8
CPT CODE: $25.6182585-8
CPT CODE: $17.6082595-8
CPT CODE: $53.3382600-8
CPT CODE: $46.0682607-8
CPT CODE: $69.3882608-8
CPT CODE: $14.3682610-8
CPT CODE: $5.0482610-P
CPT CODE: $26.1882615-8
CPT CODE: $79.0282626-8
CPT CODE: $76.5482627-8
CPT CODE: $102.7682633-8
CPT CODE: $88.9182634-8
CPT CODE: $36.8682638-8
CPT CODE: $28.4882642-8
CPT CODE: $98.8182652-8
CPT CODE: $21.9282656-8
CPT CODE: $7.7482656-P
CPT CODE: $43.7782657-8
CPT CODE: $43.7782658-8
CPT CODE: $61.2682664-8
CPT CODE: $96.6482668-8
CPT CODE: $94.8682670-8
CPT CODE: $68.2882671-8
CPT CODE: $56.0582672-8
CPT CODE: $58.3382677-8
CPT CODE: $49.3982679-8
CPT CODE: $26.7982693-8
CPT CODE: $128.4482696-8
CPT CODE: $16.8082705-8
CPT CODE: $39.5382710-8
CPT CODE: $50.1882715-8
CPT CODE: $50.7982725-8
CPT CODE: $170.4482726-8
CPT CODE: $38.8082728-8
CPT CODE: $44.8682735-8
CPT CODE: $63.2182746-8
CPT CODE: $61.2382747-8
CPT CODE: $52.8682757-8
CPT CODE: $93.2582759-8
CPT CODE: $27.7882760-8
CPT CODE: $53.3382775-8
CPT CODE: $37.5482776-8
CPT CODE: $61.2682784-8
CPT CODE: $43.9882785-8
CPT CODE: $59.4082787-8
CPT CODE: $8.0182800-8
CPT CODE: $39.1082803-8
CPT CODE: $72.8082805-8
CPT CODE: $33.6082810-8
CPT CODE: $7.6582820-8
CPT CODE: $10.7482930-8
CPT CODE: $69.1582938-8
CPT CODE: $69.1582941-8
CPT CODE: $19.7782943-8
CPT CODE: $14.0582945-8
CPT CODE: $4.2082945-P
CPT CODE: $17.7782946-8
CPT CODE: $14.8282947-8
CPT CODE: $7.9182948-8
CPT CODE: $11.0782950-8
CPT CODE: $28.7582951-8
CPT CODE: $18.4882952-8
CPT CODE: $19.1882955-8
CPT CODE: $19.7782960-8
CPT CODE: $7.6582962-8
CPT CODE: $57.3182963-8
CPT CODE: $19.7782965-8
CPT CODE: $14.6482977-8
CPT CODE: $75.1182978-8
CPT CODE: $27.6682979-8
CPT CODE: $43.3882985-8
CPT CODE: $83.0183001-8
CPT CODE: $75.1183002-8
CPT CODE: $77.0483003-8
CPT CODE: $26.0783006-8
CPT CODE: $194.8483009-8
CPT CODE: $68.7783009-P
CPT CODE: $18.3283010-8
CPT CODE: $98.8183012-8
CPT CODE: $38.2183013-8
CPT CODE: $265.7983014-8
CPT CODE: $35.1483015-8
CPT CODE: $71.1683018-8
CPT CODE: $37.3383020-8
CPT CODE: $21.6183021-8
CPT CODE: $8.4283026-8
CPT CODE: $24.0183030-8
CPT CODE: $25.6883033-8
CPT CODE: $26.3783036-8
CPT CODE: $15.5783037-8
CPT CODE: $5.5283037-P
CPT CODE: $15.8083045-8
CPT CODE: $21.7683050-8
CPT CODE: $23.7083051-8
CPT CODE: $61.2683060-8
CPT CODE: $49.3983065-8
CPT CODE: $51.3883068-8
CPT CODE: $5.6383069-8
CPT CODE: $19.7783070-8
CPT CODE: $48.1783080-8
CPT CODE: $126.4983088-8
CPT CODE: $62.2383090-8
CPT CODE: $18.6783090-P
CPT CODE: $35.5683150-8
CPT CODE: $55.3283491-8
CPT CODE: $41.6183497-8
CPT CODE: $79.0283498-8
CPT CODE: $73.4183500-8
CPT CODE: $90.6983505-8
CPT CODE: $32.6783516-8
CPT CODE: $34.4483518-8
CPT CODE: $40.1683519-8
CPT CODE: $34.4483520-8
CPT CODE: $49.3983525-8
CPT CODE: $48.5583527-8
CPT CODE: $57.3183528-8
CPT CODE: $12.7783540-8
CPT CODE: $27.6683550-8
CPT CODE: $61.2683570-8
CPT CODE: $49.1083582-8
CPT CODE: $37.3383586-8
CPT CODE: $126.4983593-8
CPT CODE: $42.7083605-8
CPT CODE: $9.0983615-8
CPT CODE: $51.3883625-8
CPT CODE: $21.9283630-8
CPT CODE: $7.7483630-P
CPT CODE: $33.2183631-8
CPT CODE: $11.1083631-P
CPT CODE: $114.6383632-8
CPT CODE: $35.5683633-8
CPT CODE: $61.1883655-8
CPT CODE: $75.1783661-8
CPT CODE: $72.7883662-8
CPT CODE: $25.2083663-8
CPT CODE: $8.9183663-P
CPT CODE: $12.5983664-8
CPT CODE: $4.4383664-P
CPT CODE: $27.1783670-8
CPT CODE: $14.8283690-8
CPT CODE: $77.0483698-8
CPT CODE: $27.1283698-P
CPT CODE: $20.7983700-8
CPT CODE: $4.8283700-P
CPT CODE: $69.6083701-8
CPT CODE: $10.9683701-P
Page 47
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $78.4883704-8
CPT CODE: $14.0683704-P
CPT CODE: $21.5483718-8
CPT CODE: $26.6983719-8
CPT CODE: $22.9583721-8
CPT CODE: $30.6883722-8
CPT CODE: $63.2183727-8
CPT CODE: $19.8783735-8
CPT CODE: $45.4583775-8
CPT CODE: $41.6183785-8
CPT CODE: $48.0283789-8
CPT CODE: $68.2883825-8
CPT CODE: $53.0683835-8
CPT CODE: $61.2683857-8
CPT CODE: $12.2583861-8
CPT CODE: $148.2083864-8
CPT CODE: $13.8183872-8
CPT CODE: $112.6483873-8
CPT CODE: $98.8183874-8
CPT CODE: $20.9583876-8
CPT CODE: $7.3883876-P
CPT CODE: $24.1183883-8
CPT CODE: $148.2083885-8
CPT CODE: $42.2083915-8
CPT CODE: $75.1183916-8
CPT CODE: $53.7283918-8
CPT CODE: $33.2383919-8
CPT CODE: $38.5283921-8
CPT CODE: $13.5683921-P
CPT CODE: $21.5483930-8
CPT CODE: $19.7783935-8
CPT CODE: $91.4883937-8
CPT CODE: $39.2183945-8
CPT CODE: $124.6683950-8
CPT CODE: $43.9783950-P
CPT CODE: $104.4983951-8
CPT CODE: $36.8683951-P
CPT CODE: $187.7383970-8
CPT CODE: $19.7783986-8
CPT CODE: $16.9883987-8
CPT CODE: $65.2083992-8
CPT CODE: $31.1783993-8
CPT CODE: $10.4283993-P
CPT CODE: $9.8884030-8
CPT CODE: $9.8884035-8
CPT CODE: $17.3884060-8
CPT CODE: $19.7784066-8
CPT CODE: $10.7684075-8
CPT CODE: $12.4384078-8
CPT CODE: $57.6284080-8
CPT CODE: $53.3384081-8
CPT CODE: $29.6484085-8
CPT CODE: $61.2684087-8
CPT CODE: $9.0984100-8
CPT CODE: $10.3984105-8
CPT CODE: $17.7784106-8
CPT CODE: $25.6884110-8
CPT CODE: $69.9684112-8
CPT CODE: $45.4584119-8
CPT CODE: $61.2684120-8
CPT CODE: $126.4984126-8
CPT CODE: $14.8284132-8
CPT CODE: $7.6184133-8
CPT CODE: $38.7484134-8
CPT CODE: $61.1184135-8
CPT CODE: $79.0284138-8
CPT CODE: $76.5484140-8
CPT CODE: $76.5484143-8
CPT CODE: $57.5084144-8
CPT CODE: $52.4984145-8
CPT CODE: $94.8684146-8
CPT CODE: $55.3284150-8
CPT CODE: $31.8284152-8
CPT CODE: $11.2284152-P
CPT CODE: $45.9284153-8
CPT CODE: $39.8784154-8
CPT CODE: $7.2284155-8
CPT CODE: $4.5784156-8
CPT CODE: $1.6384156-P
CPT CODE: $4.5784157-8
CPT CODE: $1.6384157-P
CPT CODE: $12.2284160-8
CPT CODE: $18.3484163-8
CPT CODE: $6.4484163-P
CPT CODE: $29.8384165-8
CPT CODE: $33.5284166-8
CPT CODE: $31.6084166-P
CPT CODE: $75.7384181-8
CPT CODE: $75.7384182-8
CPT CODE: $75.3784202-8
CPT CODE: $20.2384203-8
CPT CODE: $55.3284206-8
CPT CODE: $90.6984207-8
CPT CODE: $29.6484210-8
CPT CODE: $25.6184220-8
CPT CODE: $128.4484228-8
CPT CODE: $187.7384233-8
CPT CODE: $94.8684234-8
CPT CODE: $187.7384235-8
CPT CODE: $177.8484238-8
CPT CODE: $73.1084244-8
CPT CODE: $83.0184252-8
CPT CODE: $70.1784255-8
CPT CODE: $93.8684260-8
CPT CODE: $45.9284270-8
CPT CODE: $65.2084275-8
CPT CODE: $136.3784285-8
CPT CODE: $7.3184295-8
CPT CODE: $10.1884300-8
CPT CODE: $6.6184302-8
CPT CODE: $2.3384302-P
CPT CODE: $42.1184305-8
CPT CODE: $42.1184307-8
CPT CODE: $28.7184311-8
CPT CODE: $5.9284315-8
CPT CODE: $25.6884375-8
CPT CODE: $41.5484376-8
CPT CODE: $41.5484377-8
CPT CODE: $41.5484378-8
CPT CODE: $41.5484379-8
CPT CODE: $45.4584392-8
CPT CODE: $92.6184402-8
CPT CODE: $98.8184403-8
CPT CODE: $60.1984410-8
CPT CODE: $51.1784425-8
CPT CODE: $46.4284430-8
CPT CODE: $20.8484431-8
CPT CODE: $60.2484432-8
CPT CODE: $25.6884436-8
CPT CODE: $13.2484437-8
CPT CODE: $49.3984439-8
CPT CODE: $26.6984442-8
CPT CODE: $47.1384443-8
CPT CODE: $154.1584445-8
CPT CODE: $46.4284446-8
CPT CODE: $46.6784449-8
CPT CODE: $10.3984450-8
CPT CODE: $9.9884460-8
CPT CODE: $59.4084466-8
CPT CODE: $13.8184478-8
CPT CODE: $15.5384479-8
CPT CODE: $61.2684480-8
CPT CODE: $90.9184481-8
CPT CODE: $9.5484482-8
CPT CODE: $30.8984484-8
CPT CODE: $33.1084485-8
CPT CODE: $25.6884488-8
CPT CODE: $26.6984490-8
CPT CODE: $25.6884510-8
CPT CODE: $23.6584512-8
CPT CODE: $7.4084520-8
CPT CODE: $5.3684525-8
Page 48
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $11.5684540-8
CPT CODE: $21.7684545-8
CPT CODE: $7.9184550-8
CPT CODE: $9.0984560-8
CPT CODE: $154.1584577-8
CPT CODE: $6.9184578-8
CPT CODE: $49.3984580-8
CPT CODE: $10.3984583-8
CPT CODE: $48.9184585-8
CPT CODE: $67.1784586-8
CPT CODE: $132.4384588-8
CPT CODE: $30.4584590-8
CPT CODE: $20.4384591-8
CPT CODE: $7.2184591-P
CPT CODE: $61.2684597-8
CPT CODE: $75.1184600-8
CPT CODE: $45.4584620-8
CPT CODE: $23.1484630-8
CPT CODE: $31.1484681-8
CPT CODE: $29.6484702-8
CPT CODE: $18.7684703-8
CPT CODE: $16.5684704-8
CPT CODE: $5.8284704-P
CPT CODE: $8.9185002-8
CPT CODE: $9.7085004-8
CPT CODE: $3.3985004-P
CPT CODE: $11.8785007-8
CPT CODE: $13.0285008-8
CPT CODE: $11.4385009-8
CPT CODE: $9.6885013-8
CPT CODE: $9.9885014-8
CPT CODE: $8.6985018-8
CPT CODE: $28.1685025-8
CPT CODE: $13.8985027-8
CPT CODE: $8.9485032-8
CPT CODE: $2.7485032-P
CPT CODE: $6.6385041-8
CPT CODE: $12.9585044-8
CPT CODE: $13.8185045-8
CPT CODE: $11.6385046-8
CPT CODE: $8.9185048-8
CPT CODE: $8.2785049-8
CPT CODE: $2.4685049-P
CPT CODE: $99.1685055-8
CPT CODE: $34.9785055-P
CPT CODE: $33.5985060-8
CPT CODE: $63.2185060-P
CPT CODE: $130.7385097-8
CPT CODE: $181.8185097-P
CPT CODE: $9.8085170-8
CPT CODE: $19.7785175-8
CPT CODE: $41.2585210-8
CPT CODE: $116.6085220-8
CPT CODE: $73.4185230-8
CPT CODE: $62.2385240-8
CPT CODE: $98.8185244-8
CPT CODE: $95.6385245-8
CPT CODE: $95.6385246-8
CPT CODE: $95.6385247-8
CPT CODE: $73.4185250-8
CPT CODE: $102.9885260-8
CPT CODE: $73.4185270-8
CPT CODE: $73.4185280-8
CPT CODE: $73.4185290-8
CPT CODE: $49.3985291-8
CPT CODE: $17.9685292-8
CPT CODE: $116.6085293-8
CPT CODE: $45.4585300-8
CPT CODE: $21.3185301-8
CPT CODE: $51.3885302-8
CPT CODE: $95.6385303-8
CPT CODE: $53.3385305-8
CPT CODE: $95.6385306-8
CPT CODE: $66.2985307-8
CPT CODE: $23.4085307-P
CPT CODE: $95.6385335-8
CPT CODE: $47.8485337-8
CPT CODE: $12.4385345-8
CPT CODE: $19.7785347-8
CPT CODE: $11.8785348-8
CPT CODE: $55.3285360-8
CPT CODE: $19.7785362-8
CPT CODE: $19.1385366-8
CPT CODE: $19.1385370-8
CPT CODE: $19.1385378-8
CPT CODE: $19.1385379-8
CPT CODE: $12.7885380-8
CPT CODE: $4.5185380-P
CPT CODE: $22.7885384-8
CPT CODE: $22.7885385-8
CPT CODE: $27.6685390-8
CPT CODE: $54.9785397-8
CPT CODE: $19.4085397-P
CPT CODE: $27.6685400-8
CPT CODE: $7.9185410-8
CPT CODE: $95.6385415-8
CPT CODE: $19.7785420-8
CPT CODE: $27.6685421-8
CPT CODE: $11.8785441-8
CPT CODE: $17.7785445-8
CPT CODE: $21.3185460-8
CPT CODE: $19.6185461-8
CPT CODE: $95.6385475-8
CPT CODE: $17.7785520-8
CPT CODE: $44.0185525-8
CPT CODE: $75.1185530-8
CPT CODE: $12.0285536-8
CPT CODE: $27.6685540-8
CPT CODE: $61.2685547-8
CPT CODE: $104.7385549-8
CPT CODE: $13.8185555-8
CPT CODE: $35.1985557-8
CPT CODE: $48.5585576-8
CPT CODE: $44.0185597-8
CPT CODE: $17.3885598-8
CPT CODE: $14.1585610-8
CPT CODE: $8.2185611-8
CPT CODE: $8.5285612-8
CPT CODE: $8.2185613-8
CPT CODE: $29.8385635-8
CPT CODE: $9.2985651-8
CPT CODE: $8.2985652-8
CPT CODE: $11.0785660-8
CPT CODE: $23.5285670-8
CPT CODE: $47.4485675-8
CPT CODE: $17.2385705-8
CPT CODE: $17.3185730-8
CPT CODE: $19.1885732-8
CPT CODE: $20.3885810-8
CPT CODE: $11.0786000-8
CPT CODE: $12.9486001-8
CPT CODE: $4.5786001-P
CPT CODE: $18.0786003-8
CPT CODE: $76.5486005-8
CPT CODE: $20.7486008-8
CPT CODE: $18.6886021-8
CPT CODE: $19.7786022-8
CPT CODE: $26.9586023-8
CPT CODE: $45.4586038-8
CPT CODE: $29.7686039-8
CPT CODE: $20.7486060-8
CPT CODE: $17.3186063-8
CPT CODE: $59.2886077-8
CPT CODE: $17.7786077-P
CPT CODE: $72.0086078-8
CPT CODE: $21.7686078-P
CPT CODE: $51.4886079-8
CPT CODE: $16.9886140-8
CPT CODE: $99.5286146-8
CPT CODE: $35.1086146-P
CPT CODE: $143.5086147-8
CPT CODE: $126.7186148-8
Page 49
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $104.7386155-8
CPT CODE: $17.2386156-8
CPT CODE: $17.2386157-8
CPT CODE: $59.4086160-8
CPT CODE: $59.4086161-8
CPT CODE: $79.0286162-8
CPT CODE: $29.6486171-8
CPT CODE: $22.3286200-8
CPT CODE: $7.8686200-P
CPT CODE: $29.6486215-8
CPT CODE: $46.4286225-8
CPT CODE: $19.0686226-8
CPT CODE: $45.4586235-8
CPT CODE: $38.3186255-8
CPT CODE: $28.7586256-8
CPT CODE: $71.1686277-8
CPT CODE: $35.5686280-8
CPT CODE: $23.8886294-8
CPT CODE: $8.4386294-P
CPT CODE: $31.8286300-8
CPT CODE: $11.2286300-P
CPT CODE: $31.8286301-8
CPT CODE: $11.2286301-P
CPT CODE: $31.8286304-8
CPT CODE: $11.2286304-P
CPT CODE: $26.2586305-8
CPT CODE: $16.7686308-8
CPT CODE: $14.4186309-8
CPT CODE: $29.6486310-8
CPT CODE: $47.4486316-8
CPT CODE: $19.6586317-8
CPT CODE: $35.5686318-8
CPT CODE: $53.3386320-8
CPT CODE: $80.0586325-8
CPT CODE: $16.6986327-8
CPT CODE: $61.3486329-8
CPT CODE: $28.4686331-8
CPT CODE: $45.4586332-8
CPT CODE: $61.2686334-8
CPT CODE: $55.2386335-8
CPT CODE: $31.6086335-P
CPT CODE: $25.0086336-8
CPT CODE: $8.8186336-P
CPT CODE: $114.6386337-8
CPT CODE: $37.5486340-8
CPT CODE: $37.3286341-8
CPT CODE: $92.8486343-8
CPT CODE: $35.5686344-8
CPT CODE: $121.4586352-8
CPT CODE: $199.5986353-8
CPT CODE: $87.9086355-8
CPT CODE: $31.0086355-P
CPT CODE: $86.9286356-8
CPT CODE: $30.6686356-P
CPT CODE: $87.9086357-8
CPT CODE: $31.0086357-P
CPT CODE: $132.5486359-8
CPT CODE: $123.1886360-8
CPT CODE: $133.4586361-8
CPT CODE: $87.9086367-8
CPT CODE: $31.0086367-P
CPT CODE: $35.5686376-8
CPT CODE: $37.5486382-8
CPT CODE: $70.7586384-8
CPT CODE: $25.7986386-8
CPT CODE: $23.7086403-8
CPT CODE: $52.6686406-8
CPT CODE: $15.3286430-8
CPT CODE: $14.8286431-8
CPT CODE: $140.6586480-8
CPT CODE: $49.6086480-P
CPT CODE: $78.5586481-8
CPT CODE: $22.9586485-8
CPT CODE: $14.7186486-8
CPT CODE: $3.8886486-P
CPT CODE: $16.5386490-8
CPT CODE: $19.7786510-8
CPT CODE: $15.8086580-8
CPT CODE: $25.9286590-8
CPT CODE: $11.0786592-8
CPT CODE: $16.6086593-8
CPT CODE: $16.2786602-8
CPT CODE: $133.9186603-8
CPT CODE: $66.9686606-8
CPT CODE: $66.9686609-8
CPT CODE: $12.0286611-8
CPT CODE: $4.2086611-P
CPT CODE: $66.9686612-8
CPT CODE: $53.5786615-8
CPT CODE: $83.5186617-8
CPT CODE: $53.5786618-8
CPT CODE: $53.5786619-8
CPT CODE: $53.9486622-8
CPT CODE: $95.4786625-8
CPT CODE: $57.4186628-8
CPT CODE: $57.4186631-8
CPT CODE: $76.5486632-8
CPT CODE: $66.9686635-8
CPT CODE: $95.6386638-8
CPT CODE: $79.5886641-8
CPT CODE: $57.4186644-8
CPT CODE: $66.9686645-8
CPT CODE: $57.4186648-8
CPT CODE: $57.4186651-8
CPT CODE: $57.4186652-8
CPT CODE: $57.4186653-8
CPT CODE: $57.4186654-8
CPT CODE: $198.9686658-8
CPT CODE: $74.6186663-8
CPT CODE: $63.1286664-8
CPT CODE: $74.6186665-8
CPT CODE: $12.0286666-8
CPT CODE: $4.2086666-P
CPT CODE: $38.2686668-8
CPT CODE: $38.2686671-8
CPT CODE: $38.2686674-8
CPT CODE: $86.1086677-8
CPT CODE: $66.9686682-8
CPT CODE: $86.1086684-8
CPT CODE: $53.3386687-8
CPT CODE: $143.5086688-8
CPT CODE: $86.9686689-8
CPT CODE: $63.1286692-8
CPT CODE: $91.8286694-8
CPT CODE: $76.5486695-8
CPT CODE: $58.3486696-8
CPT CODE: $20.5986696-P
CPT CODE: $66.9686698-8
CPT CODE: $46.5886701-8
CPT CODE: $75.7386702-8
CPT CODE: $120.5386703-8
CPT CODE: $43.9386704-8
CPT CODE: $37.1786705-8
CPT CODE: $38.8686706-8
CPT CODE: $45.6286707-8
CPT CODE: $38.8686708-8
CPT CODE: $32.3786709-8
CPT CODE: $57.4186710-8
CPT CODE: $21.9286711-8
CPT CODE: $55.4986713-8
CPT CODE: $47.8486717-8
CPT CODE: $47.8486720-8
CPT CODE: $86.1086723-8
CPT CODE: $66.9686727-8
CPT CODE: $76.5486732-8
CPT CODE: $66.9686735-8
CPT CODE: $57.4186738-8
CPT CODE: $86.1086741-8
CPT CODE: $76.5486744-8
CPT CODE: $95.6386747-8
CPT CODE: $21.9786750-8
CPT CODE: $66.9686753-8
Page 50
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $66.9686756-8
CPT CODE: $58.3486757-8
CPT CODE: $20.5986757-P
CPT CODE: $95.6386759-8
CPT CODE: $19.0686762-8
CPT CODE: $86.1086765-8
CPT CODE: $76.5486768-8
CPT CODE: $38.2686771-8
CPT CODE: $114.7686774-8
CPT CODE: $66.9686777-8
CPT CODE: $95.6386778-8
CPT CODE: $16.4686780-8
CPT CODE: $72.7086784-8
CPT CODE: $57.4186787-8
CPT CODE: $40.2086788-8
CPT CODE: $14.1786788-P
CPT CODE: $34.4086789-8
CPT CODE: $12.1486789-P
CPT CODE: $57.4186790-8
CPT CODE: $57.4186793-8
CPT CODE: $19.4886794-8
CPT CODE: $59.2886800-8
CPT CODE: $37.1786803-8
CPT CODE: $60.8286804-8
CPT CODE: $64.3186805-8
CPT CODE: $86.9686806-8
CPT CODE: $132.4386807-8
CPT CODE: $102.7686808-8
CPT CODE: $102.7686812-8
CPT CODE: $157.4286813-8
CPT CODE: $96.5386816-8
CPT CODE: $422.9086817-8
CPT CODE: $328.0586821-8
CPT CODE: $259.3586825-8
CPT CODE: $86.4586826-8
CPT CODE: $60.2486828-8
CPT CODE: $50.2286829-8
CPT CODE: $128.9786830-8
CPT CODE: $110.5586831-8
CPT CODE: $202.6786832-8
CPT CODE: $184.2486833-8
CPT CODE: $571.1486834-8
CPT CODE: $515.8786835-8
CPT CODE: $57.4186849-8
CPT CODE: $11.4886850-8
CPT CODE: $11.4886860-8
CPT CODE: $31.0386870-8
CPT CODE: $15.0186880-8
CPT CODE: $11.2086885-8
CPT CODE: $15.0186886-8
CPT CODE: $135.8386890-8
CPT CODE: $135.8386891-8
CPT CODE: $35.9086900-8
CPT CODE: $19.1386901-8
CPT CODE: $6.5986902-8
CPT CODE: $19.1386904-8
CPT CODE: $17.2386905-8
CPT CODE: $19.1386906-8
CPT CODE: $334.8086910-8
CPT CODE: $19.1386920-8
CPT CODE: $43.0586922-8
CPT CODE: $107.1286927-8
CPT CODE: $8.6986930-8
CPT CODE: $107.1286931-8
CPT CODE: $107.1286932-8
CPT CODE: $17.2386940-8
CPT CODE: $122.4386941-8
CPT CODE: $26.7986965-8
CPT CODE: $47.8486970-8
CPT CODE: $47.8486971-8
CPT CODE: $47.8486972-8
CPT CODE: $47.8486975-8
CPT CODE: $47.8486976-8
CPT CODE: $47.8486977-8
CPT CODE: $47.8486978-8
CPT CODE: $75.1187003-8
CPT CODE: $15.5387015-8
CPT CODE: $43.2087040-8
CPT CODE: $28.2887045-8
CPT CODE: $4.7687046-8
CPT CODE: $1.6787046-P
CPT CODE: $28.6487070-8
CPT CODE: $9.5287071-8
CPT CODE: $3.3387071-P
CPT CODE: $9.5287073-8
CPT CODE: $3.3387073-P
CPT CODE: $31.0587075-8
CPT CODE: $28.1587076-8
CPT CODE: $18.5687077-8
CPT CODE: $6.5687077-P
CPT CODE: $17.7787081-8
CPT CODE: $16.0287084-8
CPT CODE: $25.2087086-8
CPT CODE: $32.6287088-8
CPT CODE: $19.1887101-8
CPT CODE: $26.2887102-8
CPT CODE: $25.6887103-8
CPT CODE: $29.6487106-8
CPT CODE: $19.9787107-8
CPT CODE: $7.0287107-P
CPT CODE: $72.9387109-8
CPT CODE: $28.1587110-8
CPT CODE: $27.6687116-8
CPT CODE: $13.8187118-8
CPT CODE: $39.5387140-8
CPT CODE: $75.1187143-8
CPT CODE: $13.2487147-8
CPT CODE: $70.9787149-8
CPT CODE: $21.2987149-P
CPT CODE: $114.8887150-8
CPT CODE: $20.7587152-8
CPT CODE: $6.2387152-P
CPT CODE: $151.2687153-8
CPT CODE: $51.3887158-8
CPT CODE: $64.8287164-8
CPT CODE: $18.5387166-8
CPT CODE: $7.8187168-8
CPT CODE: $2.3387168-P
CPT CODE: $7.8187169-8
CPT CODE: $2.3387169-P
CPT CODE: $7.8187172-8
CPT CODE: $2.3387172-P
CPT CODE: $23.7087176-8
CPT CODE: $19.6587177-8
CPT CODE: $24.7287181-8
CPT CODE: $17.3187184-8
CPT CODE: $16.5487185-8
CPT CODE: $5.8487185-P
CPT CODE: $29.6487186-8
CPT CODE: $19.9787187-8
CPT CODE: $45.4587188-8
CPT CODE: $11.8787190-8
CPT CODE: $17.7787197-8
CPT CODE: $9.2987205-8
CPT CODE: $33.5987206-8
CPT CODE: $17.9687207-8
CPT CODE: $123.9887209-8
CPT CODE: $83.2787209-P
CPT CODE: $9.8887210-8
CPT CODE: $9.5487220-8
CPT CODE: $51.3887230-8
CPT CODE: $67.0787250-8
CPT CODE: $48.9187252-8
CPT CODE: $29.6487253-8
CPT CODE: $11.2687254-8
CPT CODE: $3.3787254-P
CPT CODE: $25.4187255-8
CPT CODE: $8.9887255-P
CPT CODE: $45.6287260-8
CPT CODE: $45.6287265-8
CPT CODE: $34.5987267-8
CPT CODE: $12.1787267-P
Page 51
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $33.9487269-8
CPT CODE: $11.9687269-P
CPT CODE: $45.6287270-8
CPT CODE: $34.5987271-8
CPT CODE: $12.1787271-P
CPT CODE: $45.6287272-8
CPT CODE: $35.8887273-8
CPT CODE: $12.6387273-P
CPT CODE: $45.6287274-8
CPT CODE: $35.8887275-8
CPT CODE: $12.6387275-P
CPT CODE: $45.6287276-8
CPT CODE: $45.6287278-8
CPT CODE: $35.8887279-8
CPT CODE: $12.6387279-P
CPT CODE: $45.6287280-8
CPT CODE: $35.8887281-8
CPT CODE: $12.6387281-P
CPT CODE: $35.8887283-8
CPT CODE: $12.6387283-P
CPT CODE: $45.6287285-8
CPT CODE: $45.6287290-8
CPT CODE: $45.6287299-8
CPT CODE: $22.3887300-8
CPT CODE: $6.7087300-P
CPT CODE: $91.2187301-8
CPT CODE: $38.7287305-8
CPT CODE: $11.6287305-P
CPT CODE: $45.6287320-8
CPT CODE: $45.6287324-8
CPT CODE: $44.7687327-8
CPT CODE: $13.4387327-P
CPT CODE: $91.2187328-8
CPT CODE: $67.7387329-8
CPT CODE: $23.9087329-P
CPT CODE: $45.6287332-8
CPT CODE: $45.6287335-8
CPT CODE: $44.7687336-8
CPT CODE: $13.4387336-P
CPT CODE: $44.7687337-8
CPT CODE: $13.4387337-P
CPT CODE: $35.8887339-8
CPT CODE: $12.6387339-P
CPT CODE: $32.1187340-8
CPT CODE: $25.2787341-8
CPT CODE: $32.1187350-8
CPT CODE: $49.0187380-8
CPT CODE: $45.6287385-8
CPT CODE: $38.3287389-8
CPT CODE: $45.6287390-8
CPT CODE: $45.6287391-8
CPT CODE: $22.3887400-8
CPT CODE: $6.7087400-P
CPT CODE: $45.6287420-8
CPT CODE: $45.6287425-8
CPT CODE: $35.8887427-8
CPT CODE: $12.6387427-P
CPT CODE: $45.6287430-8
CPT CODE: $45.6287449-8
CPT CODE: $30.4087450-8
CPT CODE: $23.8887451-8
CPT CODE: $8.4387451-P
CPT CODE: $177.3987471-8
CPT CODE: $202.7287472-8
CPT CODE: $118.2687475-8
CPT CODE: $177.3987476-8
CPT CODE: $118.2687480-8
CPT CODE: $177.3987481-8
CPT CODE: $202.7287482-8
CPT CODE: $258.3487483-8
CPT CODE: $118.2687485-8
CPT CODE: $177.3987486-8
CPT CODE: $202.7287487-8
CPT CODE: $118.2687490-8
CPT CODE: $177.3987491-8
CPT CODE: $202.7287492-8
CPT CODE: $114.8887493-8
CPT CODE: $118.2687495-8
CPT CODE: $177.3987496-8
CPT CODE: $202.7287497-8
CPT CODE: $120.4987498-8
CPT CODE: $42.5087498-P
CPT CODE: $115.5287500-8
CPT CODE: $40.7587500-P
CPT CODE: $53.0587501-8
CPT CODE: $91.8087502-8
CPT CODE: $32.7287503-8
CPT CODE: $83.4987505-8
CPT CODE: $134.2687506-8
CPT CODE: $261.1887507-8
CPT CODE: $118.2687510-8
CPT CODE: $177.3987511-8
CPT CODE: $202.7287512-8
CPT CODE: $177.3987516-8
CPT CODE: $202.7287517-8
CPT CODE: $118.2687520-8
CPT CODE: $177.3987521-8
CPT CODE: $202.7287522-8
CPT CODE: $118.2687525-8
CPT CODE: $177.3987526-8
CPT CODE: $202.7287527-8
CPT CODE: $118.2687528-8
CPT CODE: $177.3987529-8
CPT CODE: $202.7287530-8
CPT CODE: $118.2687531-8
CPT CODE: $177.3987532-8
CPT CODE: $202.7287533-8
CPT CODE: $118.2687534-8
CPT CODE: $177.3987535-8
CPT CODE: $202.7287536-8
CPT CODE: $118.2687537-8
CPT CODE: $177.3987538-8
CPT CODE: $202.7287539-8
CPT CODE: $118.2687540-8
CPT CODE: $177.3987541-8
CPT CODE: $202.7287542-8
CPT CODE: $118.2687550-8
CPT CODE: $177.3987551-8
CPT CODE: $202.7287552-8
CPT CODE: $118.2687555-8
CPT CODE: $177.3987556-8
CPT CODE: $202.7287557-8
CPT CODE: $118.2687560-8
CPT CODE: $177.3987561-8
CPT CODE: $202.7287562-8
CPT CODE: $23.4987563-8
CPT CODE: $118.2687580-8
CPT CODE: $177.3987581-8
CPT CODE: $202.7287582-8
CPT CODE: $118.2687590-8
CPT CODE: $177.3987591-8
CPT CODE: $202.7287592-8
CPT CODE: $26.7287623-8
CPT CODE: $26.7287624-8
CPT CODE: $26.7287625-8
CPT CODE: $146.9087631-8
CPT CODE: $269.1787632-8
CPT CODE: $574.8187633-8
CPT CODE: $52.1387634-8
CPT CODE: $120.4987640-8
CPT CODE: $42.5087640-P
CPT CODE: $120.4987641-8
CPT CODE: $42.5087641-P
CPT CODE: $118.2687650-8
CPT CODE: $177.3987651-8
CPT CODE: $202.7287652-8
CPT CODE: $120.4987653-8
CPT CODE: $42.5087653-P
CPT CODE: $87.8087660-8
CPT CODE: $30.9987660-P
CPT CODE: $36.1887661-8
CPT CODE: $30.6387662-8
Page 52
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $118.2687797-8
CPT CODE: $177.3987798-8
CPT CODE: $202.7287799-8
CPT CODE: $70.9787800-8
CPT CODE: $21.2987800-P
CPT CODE: $113.5487801-8
CPT CODE: $34.0887801-P
CPT CODE: $24.6887802-8
CPT CODE: $12.4987802-P
CPT CODE: $35.5087803-8
CPT CODE: $12.4987803-P
CPT CODE: $28.5487806-8
CPT CODE: $22.9387807-8
CPT CODE: $11.6187807-P
CPT CODE: $21.5987808-8
CPT CODE: $10.9387808-P
CPT CODE: $20.7087809-8
CPT CODE: $10.4887809-P
CPT CODE: $45.6287810-8
CPT CODE: $45.6287850-8
CPT CODE: $45.6287880-8
CPT CODE: $45.6287899-8
CPT CODE: $569.3087901-8
CPT CODE: $170.0287901-P
CPT CODE: $781.4387903-8
CPT CODE: $233.9687903-P
CPT CODE: $32.7787904-8
CPT CODE: $11.6087904-P
CPT CODE: $15.7787905-8
CPT CODE: $5.5887905-P
CPT CODE: $90.1687906-8
CPT CODE: $168.4987910-8
CPT CODE: $168.4987912-8
CPT CODE: $92.8488104-8
CPT CODE: $71.1688104-P
CPT CODE: $81.0488106-8
CPT CODE: $81.0488106-P
CPT CODE: $81.0488108-8
CPT CODE: $71.1688108-P
CPT CODE: $150.5188112-8
CPT CODE: $82.6488112-P
CPT CODE: $645.0188120-8
CPT CODE: $75.9788120-P
CPT CODE: $544.7188121-8
CPT CODE: $67.0988121-P
CPT CODE: $160.0788125-8
CPT CODE: $51.3888125-P
CPT CODE: $102.7688130-8
CPT CODE: $81.0488130-P
CPT CODE: $29.6488140-8
CPT CODE: $81.0488140-P
CPT CODE: $19.4388141-8
CPT CODE: $15.2188141-P
CPT CODE: $31.2688142-8
CPT CODE: $9.2988142-P
CPT CODE: $30.7488143-8
CPT CODE: $14.1488147-8
CPT CODE: $9.9588147-P
CPT CODE: $14.1488148-8
CPT CODE: $9.9588148-P
CPT CODE: $16.8088150-8
CPT CODE: $11.8788150-P
CPT CODE: $14.3688152-8
CPT CODE: $10.1488152-P
CPT CODE: $14.1488153-8
CPT CODE: $9.9588153-P
CPT CODE: $15.4388155-8
CPT CODE: $15.8088155-P
CPT CODE: $63.2188160-8
CPT CODE: $63.2188160-P
CPT CODE: $63.2188161-8
CPT CODE: $25.6888161-P
CPT CODE: $116.6088162-8
CPT CODE: $116.6088162-P
CPT CODE: $14.1488164-8
CPT CODE: $9.9588164-P
CPT CODE: $14.1488165-8
CPT CODE: $9.9588165-P
CPT CODE: $14.1488166-8
CPT CODE: $9.9588166-P
CPT CODE: $14.1488167-8
CPT CODE: $9.9588167-P
CPT CODE: $98.8188172-8
CPT CODE: $98.8188172-P
CPT CODE: $213.4288173-8
CPT CODE: $98.8188173-P
CPT CODE: $37.6088174-8
CPT CODE: $9.0288174-P
CPT CODE: $37.6088175-8
CPT CODE: $9.0288175-P
CPT CODE: $39.7988177-8
CPT CODE: $30.9688177-P
CPT CODE: $335.9588182-8
CPT CODE: $225.2788182-P
CPT CODE: $77.0088184-8
CPT CODE: $77.0088185-8
CPT CODE: $107.8588187-8
CPT CODE: $107.8588187-P
CPT CODE: $134.6088188-8
CPT CODE: $134.6088188-P
CPT CODE: $177.3688189-8
CPT CODE: $177.3688189-P
CPT CODE: $583.4188230-8
CPT CODE: $711.4488233-8
CPT CODE: $711.4488235-8
CPT CODE: $464.3888237-8
CPT CODE: $711.4488239-8
CPT CODE: $711.4488245-8
CPT CODE: $424.8888248-8
CPT CODE: $392.0188249-8
CPT CODE: $264.7988261-8
CPT CODE: $355.7588262-8
CPT CODE: $711.4488263-8
CPT CODE: $332.2288264-8
CPT CODE: $592.8788267-8
CPT CODE: $484.1788269-8
CPT CODE: $38.2188271-8
CPT CODE: $21.6188272-8
CPT CODE: $64.7988273-8
CPT CODE: $166.0988274-8
CPT CODE: $297.3588275-8
CPT CODE: $76.7088280-8
CPT CODE: $116.6088283-8
CPT CODE: $25.6888285-8
CPT CODE: $92.6188289-8
CPT CODE: $63.2188300-8
CPT CODE: $21.7688300-P
CPT CODE: $106.7288302-8
CPT CODE: $94.8688302-P
CPT CODE: $142.2988304-8
CPT CODE: $102.7688304-P
CPT CODE: $195.6588305-8
CPT CODE: $187.7388305-P
CPT CODE: $345.8488307-8
CPT CODE: $345.8488307-P
CPT CODE: $444.6588309-8
CPT CODE: $444.6588309-P
CPT CODE: $55.3288311-8
CPT CODE: $55.3288311-P
CPT CODE: $47.4488312-8
CPT CODE: $47.4488312-P
CPT CODE: $51.3888313-8
CPT CODE: $49.3988313-P
CPT CODE: $21.7688314-8
CPT CODE: $21.7688314-P
CPT CODE: $33.5988319-8
CPT CODE: $33.5988319-P
CPT CODE: $126.4988321-8
CPT CODE: $126.4988321-P
CPT CODE: $175.8688323-8
CPT CODE: $185.7788323-P
CPT CODE: $167.9988325-8
Page 53
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $167.9988325-P
CPT CODE: $120.5388329-8
CPT CODE: $120.5388329-P
CPT CODE: $217.4188331-8
CPT CODE: $187.7388331-P
CPT CODE: $112.6488332-8
CPT CODE: $100.8088332-P
CPT CODE: $168.0688333-8
CPT CODE: $147.4088333-P
CPT CODE: $89.5488334-8
CPT CODE: $78.5388334-P
CPT CODE: $84.4288341-8
CPT CODE: $39.5788341-P
CPT CODE: $165.9988342-8
CPT CODE: $160.0788342-P
CPT CODE: $126.5988344-8
CPT CODE: $49.2188344-P
CPT CODE: $177.8488346-8
CPT CODE: $100.8088346-P
CPT CODE: $711.4488348-8
CPT CODE: $671.9288348-P
CPT CODE: $84.4288350-8
CPT CODE: $42.5488350-P
CPT CODE: $183.7788355-8
CPT CODE: $183.7788356-8
CPT CODE: $183.7788358-8
CPT CODE: $150.7688360-8
CPT CODE: $88.2688360-P
CPT CODE: $138.7088361-8
CPT CODE: $78.2188361-P
CPT CODE: $53.7588363-8
CPT CODE: $112.5788364-8
CPT CODE: $31.0688364-P
CPT CODE: $316.2188365-8
CPT CODE: $280.3088367-8
CPT CODE: $103.1188367-P
CPT CODE: $256.1588368-8
CPT CODE: $111.7488368-P
CPT CODE: $75.7388371-8
CPT CODE: $267.8388372-8
CPT CODE: $59.8388387-8
CPT CODE: $47.6088387-P
CPT CODE: $35.3888388-8
CPT CODE: $29.5988388-P
CPT CODE: $9.9588720-8
CPT CODE: $2.9988720-P
CPT CODE: $9.9188738-8
CPT CODE: $9.9588740-8
CPT CODE: $2.9988740-P
CPT CODE: $9.9588741-8
CPT CODE: $2.9988741-P
CPT CODE: $233.2289049-8
CPT CODE: $87.5789049-P
CPT CODE: $21.3189050-8
CPT CODE: $15.2189051-8
CPT CODE: $7.0789055-8
CPT CODE: $2.1289055-P
CPT CODE: $17.0989060-8
CPT CODE: $12.8589125-8
CPT CODE: $17.7789160-8
CPT CODE: $12.4389190-8
CPT CODE: $10.1989220-8
CPT CODE: $37.6389230-8
CPT CODE: $15.3289300-8
CPT CODE: $14.9389310-8
CPT CODE: $33.2389320-8
CPT CODE: $26.2189321-8
CPT CODE: $7.8789321-P
CPT CODE: $32.0889322-8
CPT CODE: $9.6389322-P
CPT CODE: $125.4989325-8
CPT CODE: $47.4489330-8
CPT CODE: $34.4189331-8
CPT CODE: $9.5889331-P
CPT CODE: $894.1889337-8
CPT CODE: $1,192.6690371-6
CPT CODE: $1,192.6690371-A
CPT CODE: $1,192.6690371-N
CPT CODE: $1,325.5690375-6
CPT CODE: $1,325.5690375-A
CPT CODE: $1,325.5690375-N
CPT CODE: $1,290.6890376-6
CPT CODE: $1,290.6890376-A
CPT CODE: $1,290.6890376-N
CPT CODE: $197.6790384-6
CPT CODE: $73.0990385-6
CPT CODE: $114.6390389-6
CPT CODE: $114.6390389-A
CPT CODE: $114.6390389-N
CPT CODE: $1,028.2590396-6
CPT CODE: $1,028.2590396-A
CPT CODE: $1,028.2590396-N
CPT CODE: $25.8790460-6
CPT CODE: $25.8790460-A
CPT CODE: $25.8790460-N
CPT CODE: $14.5490461-6
CPT CODE: $14.5490461-A
CPT CODE: $14.5490461-N
CPT CODE: $9.9590471-6
CPT CODE: $9.9590471-A
CPT CODE: $9.9590471-N
CPT CODE: $26.5790472-6
CPT CODE: $26.5790472-A
CPT CODE: $26.5790472-N
CPT CODE: $9.2590473-6
CPT CODE: $9.2590473-A
CPT CODE: $9.2590473-N
CPT CODE: $9.2590474-6
CPT CODE: $9.2590474-A
CPT CODE: $9.2590474-N
CPT CODE: $320.5990586-Q
CPT CODE: $197.8890620-6
CPT CODE: $197.8890620-6
CPT CODE: $142.4990621-6
CPT CODE: $142.4990621-6
CPT CODE: $27.5290630-6
CPT CODE: $107.9990632-6
CPT CODE: $43.1890633-6
CPT CODE: $43.1890634-6
CPT CODE: $39.8790647-6
CPT CODE: $44.8590648-6
CPT CODE: $185.7490651-6
CPT CODE: $22.2790654-2
CPT CODE: $22.1390655-6
CPT CODE: $8.3290657-6
CPT CODE: $8.3290658-6
CPT CODE: $159.3190670-6
CPT CODE: $43.0490673-6
CPT CODE: $27.6290674-6
CPT CODE: $219.2790675-6
CPT CODE: $219.2790675-A
CPT CODE: $219.2790675-N
CPT CODE: $132.8990676-6
CPT CODE: $88.0690680-6
CPT CODE: $157.1790681-6
CPT CODE: $53.2090682-6
CPT CODE: $72.8090696-6
CPT CODE: $52.2590700-A
CPT CODE: $52.2590700-N
CPT CODE: $23.7090702-6
CPT CODE: $23.7090702-A
CPT CODE: $23.7090702-N
CPT CODE: $81.4890707-6
CPT CODE: $81.4890707-A
CPT CODE: $81.4890707-N
CPT CODE: $55.5890713-6
CPT CODE: $55.5890713-A
CPT CODE: $55.5890713-N
CPT CODE: $27.9090714-6
CPT CODE: $27.9090714-A
CPT CODE: $27.9090714-N
CPT CODE: $57.3690715-6
Page 54
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $57.3690715-A
CPT CODE: $57.3690715-N
CPT CODE: $49.3990732-6
CPT CODE: $49.3990732-A
CPT CODE: $49.3990732-N
CPT CODE: $102.5690734-6
CPT CODE: $295.1690740-6
CPT CODE: $104.9590743-6
CPT CODE: $54.8290744-6
CPT CODE: $125.5390746-6
CPT CODE: $318.2390747-6
CPT CODE: $92.9390748-6
CPT CODE: $25.6290756-6
CPT CODE: $5.9090785-C
CPT CODE: $183.5690791-C
CPT CODE: $194.0490792-C
CPT CODE: $79.4390832-C
CPT CODE: $56.7690833-C
CPT CODE: $107.1990834-C
CPT CODE: $94.0690836-C
CPT CODE: $158.0190837-C
CPT CODE: $138.4190838-C
CPT CODE: $158.0190839-C
CPT CODE: $56.7690840-C
CPT CODE: $187.1790845-B
CPT CODE: $187.1790845-C
CPT CODE: $187.1790845-X
CPT CODE: $159.6290846-B
CPT CODE: $159.6290846-C
CPT CODE: $159.6290846-X
CPT CODE: $190.2890847-B
CPT CODE: $190.2890847-C
CPT CODE: $190.2890847-X
CPT CODE: $106.0690849-B
CPT CODE: $106.0690849-C
CPT CODE: $106.0690849-X
CPT CODE: $85.7990853-B
CPT CODE: $85.7990853-C
CPT CODE: $85.7990853-X
CPT CODE: $73.8390863-C
CPT CODE: $371.4790865-2
CPT CODE: $371.4790865-B
CPT CODE: $371.4790865-C
CPT CODE: $371.4790865-X
CPT CODE: $504.7790869-2
CPT CODE: $293.2390870-B
CPT CODE: $293.2390870-C
CPT CODE: $293.2390870-X
CPT CODE: $126.0890875-C
CPT CODE: $171.0590876-C
CPT CODE: $182.4990880-C
CPT CODE: $219.1590885-C
CPT CODE: $184.0590887-C
CPT CODE: $46.4690912-6
CPT CODE: $25.7990913-6
CPT CODE: $241.1190935-6
CPT CODE: $523.7090937-6
CPT CODE: $241.1190945-6
CPT CODE: $523.7090947-6
CPT CODE: $612.9790951-6
CPT CODE: $612.9790952-6
CPT CODE: $612.9790953-6
CPT CODE: $592.2990954-6
CPT CODE: $592.2990955-6
CPT CODE: $592.2990956-6
CPT CODE: $580.6490957-6
CPT CODE: $580.6490958-6
CPT CODE: $580.6490959-6
CPT CODE: $517.2890960-6
CPT CODE: $517.2890961-6
CPT CODE: $517.2890962-6
CPT CODE: $612.9790963-6
CPT CODE: $592.2990964-6
CPT CODE: $580.6490965-6
CPT CODE: $517.2890966-6
CPT CODE: $21.9890967-6
CPT CODE: $19.4090968-6
CPT CODE: $18.1190969-6
CPT CODE: $18.1190970-6
CPT CODE: $1,363.6090989-6
CPT CODE: $148.2091010-6
CPT CODE: $279.3291013-6
CPT CODE: $107.4491013-P
CPT CODE: $98.8191020-6
CPT CODE: $77.1491022-6
CPT CODE: $61.9991022-P
CPT CODE: $128.4491030-6
CPT CODE: $224.9391034-6
CPT CODE: $157.5991034-P
CPT CODE: $104.5891040-6
CPT CODE: $88.8391040-P
CPT CODE: $63.2191065-6
CPT CODE: $1,012.2891110-5
CPT CODE: $180.0391110-P
CPT CODE: $1,241.5291112-6
CPT CODE: $124.9591112-P
CPT CODE: $215.7491117-6
CPT CODE: $193.4191120-6
CPT CODE: $128.9491120-P
CPT CODE: $160.0791122-6
CPT CODE: $38.6591200-6
CPT CODE: $15.5091200-P
CPT CODE: $110.6792002-6
CPT CODE: $110.6792002-A
CPT CODE: $110.6792002-M
CPT CODE: $110.6792002-N
CPT CODE: $112.6492004-6
CPT CODE: $112.6492004-A
CPT CODE: $112.6492004-M
CPT CODE: $112.6492004-N
CPT CODE: $73.1092012-6
CPT CODE: $73.1092012-A
CPT CODE: $73.1092012-M
CPT CODE: $73.1092012-N
CPT CODE: $104.7392014-6
CPT CODE: $104.7392014-A
CPT CODE: $104.7392014-M
CPT CODE: $104.7392014-N
CPT CODE: $513.8392018-6
CPT CODE: $513.8392018-A
CPT CODE: $513.8392018-M
CPT CODE: $513.8392018-N
CPT CODE: $474.2792019-6
CPT CODE: $474.2792019-A
CPT CODE: $474.2792019-M
CPT CODE: $474.2792019-N
CPT CODE: $55.3292020-6
CPT CODE: $55.3292020-A
CPT CODE: $55.3292020-M
CPT CODE: $55.3292020-N
CPT CODE: $110.6492025-6
CPT CODE: $57.3192060-6
CPT CODE: $57.3192060-A
CPT CODE: $57.3192060-M
CPT CODE: $57.3192060-N
CPT CODE: $47.4492065-6
CPT CODE: $47.4492065-A
CPT CODE: $47.4492065-M
CPT CODE: $47.4492065-N
CPT CODE: $44.8392071-2
CPT CODE: $142.9892072-2
CPT CODE: $63.2192081-6
CPT CODE: $63.2192081-A
CPT CODE: $63.2192081-M
CPT CODE: $63.2192081-N
CPT CODE: $73.1092082-6
CPT CODE: $73.1092082-A
CPT CODE: $73.1092082-M
CPT CODE: $73.1092082-N
CPT CODE: $175.8692083-6
CPT CODE: $175.8692083-A
CPT CODE: $175.8692083-M
Page 55
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $175.8692083-N
CPT CODE: $47.4492100-6
CPT CODE: $47.4492100-A
CPT CODE: $47.4492100-M
CPT CODE: $47.4492100-N
CPT CODE: $61.9392132-6
CPT CODE: $27.1792132-P
CPT CODE: $61.9392133-6
CPT CODE: $27.1792133-P
CPT CODE: $61.9392134-6
CPT CODE: $27.1792134-P
CPT CODE: $169.8792136-6
CPT CODE: $169.8792136-A
CPT CODE: $169.8792136-M
CPT CODE: $169.8792136-N
CPT CODE: $79.9392136-P
CPT CODE: $16.7892145-6
CPT CODE: $9.2292145-P
CPT CODE: $23.7792201-6
CPT CODE: $15.3892202-6
CPT CODE: $60.6692227-A
CPT CODE: $60.6692227-N
CPT CODE: $60.6692227-P
CPT CODE: $60.6692228-A
CPT CODE: $60.6692228-N
CPT CODE: $60.6692228-P
CPT CODE: $136.3792230-6
CPT CODE: $136.3792230-A
CPT CODE: $136.3792230-M
CPT CODE: $136.3792230-N
CPT CODE: $395.2692235-6
CPT CODE: $395.2692235-A
CPT CODE: $395.2692235-M
CPT CODE: $395.2692235-N
CPT CODE: $386.2092240-6
CPT CODE: $308.9192242-6
CPT CODE: $94.8692250-6
CPT CODE: $94.8692250-A
CPT CODE: $94.8692250-M
CPT CODE: $94.8692250-N
CPT CODE: $71.1692260-6
CPT CODE: $71.1692260-A
CPT CODE: $71.1692260-M
CPT CODE: $71.1692260-N
CPT CODE: $49.3992265-6
CPT CODE: $49.3992265-A
CPT CODE: $49.3992265-M
CPT CODE: $49.3992265-N
CPT CODE: $203.5292270-6
CPT CODE: $203.5292270-A
CPT CODE: $203.5292270-M
CPT CODE: $203.5292270-N
CPT CODE: $136.0392273-5
CPT CODE: $40.2392273-P
CPT CODE: $95.7892273-TC
CPT CODE: $92.6492274-5
CPT CODE: $35.6692274-P
CPT CODE: $56.9992274-TC
CPT CODE: $195.6592284-6
CPT CODE: $195.6592284-A
CPT CODE: $195.6592284-M
CPT CODE: $195.6592284-N
CPT CODE: $75.1192285-6
CPT CODE: $75.1192285-M
CPT CODE: $296.4392286-6
CPT CODE: $296.4392286-A
CPT CODE: $296.4392286-M
CPT CODE: $296.4392286-N
CPT CODE: $375.4692310-6
CPT CODE: $375.4692310-M
CPT CODE: $81.0492352-6
CPT CODE: $81.0492352-M
CPT CODE: $81.0492353-6
CPT CODE: $81.0492353-M
CPT CODE: $49.3992502-6
CPT CODE: $162.0392502-M
CPT CODE: $223.3192504-6
CPT CODE: $130.4292507-6
CPT CODE: $217.4192511-6
CPT CODE: $128.4492512-6
CPT CODE: $81.0492516-6
CPT CODE: $87.5592521-6
CPT CODE: $73.8392522-6
CPT CODE: $147.6792523-6
CPT CODE: $74.1192524-6
CPT CODE: $43.4792531-6
CPT CODE: $67.1792532-6
CPT CODE: $61.2692533-6
CPT CODE: $67.1792534-6
CPT CODE: $44.5292537-6
CPT CODE: $35.7992537-P
CPT CODE: $47.6192538-6
CPT CODE: $168.5392540-6
CPT CODE: $78.4792540-P
CPT CODE: $225.2792541-6
CPT CODE: $211.4592542-6
CPT CODE: $63.2192544-6
CPT CODE: $65.2092545-6
CPT CODE: $280.6392546-6
CPT CODE: $37.5492547-6
CPT CODE: $65.1192549-5
CPT CODE: $47.2592549-P
CPT CODE: $17.8792549-TC
CPT CODE: $36.6692550-6
CPT CODE: $49.3992551-6
CPT CODE: $49.3992551-V
CPT CODE: $47.4492552-6
CPT CODE: $47.4492552-V
CPT CODE: $63.2192553-6
CPT CODE: $63.2192553-V
CPT CODE: $33.5992555-6
CPT CODE: $33.5992555-V
CPT CODE: $45.4592556-6
CPT CODE: $45.4592556-V
CPT CODE: $92.8492557-6
CPT CODE: $92.8492557-V
CPT CODE: $35.1492558-2
CPT CODE: $11.4992558-P
CPT CODE: $21.7692559-6
CPT CODE: $21.7692559-V
CPT CODE: $41.4892560-6
CPT CODE: $41.4892560-V
CPT CODE: $35.5692561-6
CPT CODE: $35.5692561-V
CPT CODE: $13.8192562-6
CPT CODE: $13.8192562-V
CPT CODE: $13.8192563-6
CPT CODE: $13.8192563-V
CPT CODE: $13.8192564-6
CPT CODE: $13.8192564-V
CPT CODE: $23.7092565-6
CPT CODE: $23.7092565-V
CPT CODE: $51.3892567-6
CPT CODE: $51.3892567-V
CPT CODE: $39.5392568-6
CPT CODE: $39.5392568-V
CPT CODE: $90.0592570-6
CPT CODE: $90.0592570-V
CPT CODE: $65.2092571-6
CPT CODE: $65.2092571-V
CPT CODE: $41.4892572-6
CPT CODE: $41.4892572-V
CPT CODE: $45.4592575-6
CPT CODE: $45.4592575-V
CPT CODE: $45.4592576-6
CPT CODE: $45.4592576-V
CPT CODE: $23.7092577-6
CPT CODE: $23.7092577-V
CPT CODE: $146.7392579-6
CPT CODE: $51.3892582-6
CPT CODE: $148.2092583-6
CPT CODE: $221.3392584-6
Page 56
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $335.9592585-6
CPT CODE: $39.9492587-6
CPT CODE: $65.3592588-6
CPT CODE: $111.2692601-6
CPT CODE: $111.2692602-6
CPT CODE: $100.7592603-6
CPT CODE: $100.7592604-6
CPT CODE: $111.2692605-6
CPT CODE: $111.2692606-6
CPT CODE: $111.2692607-6
CPT CODE: $55.6492608-6
CPT CODE: $111.2692609-6
CPT CODE: $111.2692610-6
CPT CODE: $136.8392611-6
CPT CODE: $156.3992612-6
CPT CODE: $63.1592613-P
CPT CODE: $175.9392614-6
CPT CODE: $70.6792615-P
CPT CODE: $45.1092616-6
CPT CODE: $78.2092617-P
CPT CODE: $34.9792618-2
CPT CODE: $51.5892620-6
CPT CODE: $12.8992621-6
CPT CODE: $45.8592625-6
CPT CODE: $26.1892626-6
CPT CODE: $26.1892627-6
CPT CODE: $179.0892630-6
CPT CODE: $179.0892633-6
CPT CODE: $1,307.3192920-6
CPT CODE: $427.5392921-6
CPT CODE: $1,598.3592924-6
CPT CODE: $292.9092925-6
CPT CODE: $1,313.3092928-6
CPT CODE: $597.6092929-6
CPT CODE: $1,753.8292933-6
CPT CODE: $292.9092934-6
CPT CODE: $1,524.2492937-6
CPT CODE: $292.9092938-6
CPT CODE: $1,753.8292941-6
CPT CODE: $1,753.8292943-6
CPT CODE: $292.9092944-6
CPT CODE: $306.3092950-6
CPT CODE: $306.3092950-A
CPT CODE: $375.4692953-6
CPT CODE: $365.5892960-6
CPT CODE: $365.5892960-A
CPT CODE: $485.2392961-6
CPT CODE: $300.8492961-P
CPT CODE: $1,211.0792973-6
CPT CODE: $493.6892974-6
CPT CODE: $5,721.1592986-6
CPT CODE: $5,255.8792987-6
CPT CODE: $5,721.1592990-6
CPT CODE: $3,079.6092992-6
CPT CODE: $6,159.2092993-6
CPT CODE: $2,728.2892997-6
CPT CODE: $1,326.1492998-6
CPT CODE: $92.8493000-6
CPT CODE: $92.8493000-A
CPT CODE: $92.8493000-N
CPT CODE: $75.1193005-6
CPT CODE: $75.1193005-A
CPT CODE: $75.1193005-N
CPT CODE: $27.6693010-6
CPT CODE: $39.5393010-A
CPT CODE: $39.5393010-N
CPT CODE: $335.9593015-6
CPT CODE: $105.5693016-6
CPT CODE: $100.8093017-6
CPT CODE: $193.6693018-6
CPT CODE: $839.9193024-6
CPT CODE: $839.9193024-A
CPT CODE: $839.9193024-N
CPT CODE: $57.3193040-6
CPT CODE: $13.8193041-6
CPT CODE: $19.7793042-6
CPT CODE: $533.5993224-6
CPT CODE: $124.5093225-6
CPT CODE: $213.4293226-6
CPT CODE: $195.6593227-6
CPT CODE: $71.7293260-6
CPT CODE: $46.6093260-P
CPT CODE: $60.7593261-6
CPT CODE: $43.6993261-P
CPT CODE: $294.4193268-6
CPT CODE: $74.4693270-6
CPT CODE: $145.2593271-6
CPT CODE: $59.9293272-6
CPT CODE: $171.9393278-6
CPT CODE: $81.0493278-P
CPT CODE: $69.9393279-6
CPT CODE: $45.1293279-P
CPT CODE: $82.5793280-6
CPT CODE: $54.1593280-P
CPT CODE: $96.5693281-6
CPT CODE: $63.1793281-P
CPT CODE: $89.3393282-6
CPT CODE: $59.1193282-P
CPT CODE: $108.7493283-6
CPT CODE: $74.4593283-P
CPT CODE: $127.2493284-6
CPT CODE: $88.4493284-P
CPT CODE: $60.4693285-6
CPT CODE: $37.0093285-P
CPT CODE: $34.2993286-6
CPT CODE: $18.9593286-P
CPT CODE: $45.1293287-6
CPT CODE: $27.5293287-P
CPT CODE: $54.1593288-6
CPT CODE: $30.2493288-P
CPT CODE: $83.0393289-6
CPT CODE: $54.6093289-P
CPT CODE: $40.1593290-6
CPT CODE: $26.6393290-P
CPT CODE: $51.8993291-6
CPT CODE: $30.6993291-P
CPT CODE: $46.9393292-6
CPT CODE: $30.2493292-P
CPT CODE: $74.9093293-6
CPT CODE: $21.2193293-P
CPT CODE: $46.0293294-6
CPT CODE: $83.0393295-6
CPT CODE: $45.5793296-6
CPT CODE: $32.0393297-6
CPT CODE: $37.0093298-6
CPT CODE: $569.8393303-6
CPT CODE: $257.4793303-P
CPT CODE: $375.8993304-6
CPT CODE: $99.5793304-P
CPT CODE: $334.8093306-6
CPT CODE: $334.8093306-A
CPT CODE: $334.8093306-N
CPT CODE: $89.7993306-P
CPT CODE: $464.3893307-6
CPT CODE: $464.3893307-A
CPT CODE: $464.3893307-N
CPT CODE: $205.5293307-P
CPT CODE: $294.4793308-6
CPT CODE: $294.4793308-A
CPT CODE: $294.4793308-N
CPT CODE: $81.0493308-P
CPT CODE: $1,027.6593312-6
CPT CODE: $622.5093312-P
CPT CODE: $168.3793313-6
CPT CODE: $168.3793313-P
CPT CODE: $185.5993314-6
CPT CODE: $185.5993314-P
CPT CODE: $1,287.2993315-6
CPT CODE: $784.4193315-P
CPT CODE: $211.1293316-6
CPT CODE: $209.4193316-P
CPT CODE: $236.8493317-6
Page 57
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $235.1593317-P
CPT CODE: $268.7793320-6
CPT CODE: $268.7793320-A
CPT CODE: $268.7793320-N
CPT CODE: $71.1693320-P
CPT CODE: $294.4793321-6
CPT CODE: $81.0493321-P
CPT CODE: $780.6093350-6
CPT CODE: $346.5293351-6
CPT CODE: $48.2893352-6
CPT CODE: $255.7793355-6
CPT CODE: $12.4893356-5
CPT CODE: $979.5193451-6
CPT CODE: $518.2093451-P
CPT CODE: $1,536.8993452-6
CPT CODE: $589.6193452-P
CPT CODE: $1,933.7693453-6
CPT CODE: $982.6793453-P
CPT CODE: $1,581.1393454-6
CPT CODE: $736.8593454-P
CPT CODE: $2,200.4393455-6
CPT CODE: $906.2193455-P
CPT CODE: $1,983.6893456-6
CPT CODE: $965.6193456-P
CPT CODE: $2,602.9893457-6
CPT CODE: $1,134.9893457-P
CPT CODE: $2,003.2793458-6
CPT CODE: $801.9493458-P
CPT CODE: $2,622.5793459-6
CPT CODE: $967.5193459-P
CPT CODE: $2,400.1393460-6
CPT CODE: $1,195.0193460-P
CPT CODE: $3,019.4493461-6
CPT CODE: $1,364.3893461-P
CPT CODE: $425.9493462-6
CPT CODE: $161.6193463-6
CPT CODE: $383.6393464-6
CPT CODE: $142.2693464-P
CPT CODE: $800.3893503-6
CPT CODE: $793.9293503-P
CPT CODE: $800.3893505-6
CPT CODE: $800.3893505-P
CPT CODE: $778.7993530-6
CPT CODE: $1,307.5493531-6
CPT CODE: $1,255.1993532-6
CPT CODE: $1,307.5493533-6
CPT CODE: $671.9293561-6
CPT CODE: $671.9293561-P
CPT CODE: $165.9993562-6
CPT CODE: $165.9993562-P
CPT CODE: $466.3893563-6
CPT CODE: $841.7693564-6
CPT CODE: $323.5593565-6
CPT CODE: $381.6993566-6
CPT CODE: $319.1493567-6
CPT CODE: $249.6293568-6
CPT CODE: $2,620.8793580-6
CPT CODE: $772.4993582-6
CPT CODE: $859.8193583-6
CPT CODE: $1,300.4993590-6
CPT CODE: $1,079.1993591-6
CPT CODE: $475.5793592-6
CPT CODE: $326.0793600-6
CPT CODE: $326.0793600-P
CPT CODE: $365.5893602-6
CPT CODE: $365.5893602-P
CPT CODE: $375.4693603-6
CPT CODE: $375.4693603-P
CPT CODE: $543.4693610-6
CPT CODE: $543.4693610-P
CPT CODE: $375.4693612-6
CPT CODE: $375.4693612-P
CPT CODE: $375.4693618-6
CPT CODE: $375.4693618-P
CPT CODE: $1,987.7593619-6
CPT CODE: $793.2493619-P
CPT CODE: $2,401.0993620-6
CPT CODE: $2,401.0993620-P
CPT CODE: $2,776.6093621-6
CPT CODE: $2,776.6093621-P
CPT CODE: $2,776.6093622-6
CPT CODE: $2,776.6093622-P
CPT CODE: $375.4693623-6
CPT CODE: $375.4693623-P
CPT CODE: $741.0893624-6
CPT CODE: $741.0893624-P
CPT CODE: $3,883.2893631-6
CPT CODE: $3,883.2893631-P
CPT CODE: $375.4693640-6
CPT CODE: $375.4693640-P
CPT CODE: $373.2993641-6
CPT CODE: $149.3393641-P
CPT CODE: $373.2993642-6
CPT CODE: $149.3393642-P
CPT CODE: $325.4993644-6
CPT CODE: $202.0193644-P
CPT CODE: $5,414.8593650-6
CPT CODE: $5,414.8593650-P
CPT CODE: $2,106.5893653-6
CPT CODE: $2,532.1193654-6
CPT CODE: $480.3393655-6
CPT CODE: $2,532.1193656-6
CPT CODE: $480.5493657-6
CPT CODE: $251.0093660-6
CPT CODE: $251.0093660-P
CPT CODE: $118.1393702-6
CPT CODE: $113.8793724-6
CPT CODE: $44.7993724-P
CPT CODE: $100.2893745-6
CPT CODE: $35.8293745-P
CPT CODE: $7.9193770-6
CPT CODE: $54.7793792-6
CPT CODE: $12.7493793-6
CPT CODE: $642.2793880-6
CPT CODE: $292.4993880-P
CPT CODE: $215.3993882-6
CPT CODE: $98.8193882-P
CPT CODE: $303.7593886-6
CPT CODE: $146.2693886-P
CPT CODE: $83.0193888-6
CPT CODE: $49.3993888-P
CPT CODE: $317.2893922-6
CPT CODE: $173.5993922-P
CPT CODE: $317.2893923-6
CPT CODE: $173.5993923-P
CPT CODE: $335.9593924-6
CPT CODE: $175.4493924-P
CPT CODE: $335.9593925-6
CPT CODE: $175.8693925-P
CPT CODE: $112.6493926-6
CPT CODE: $59.2893926-P
CPT CODE: $263.0193930-6
CPT CODE: $167.9993930-P
CPT CODE: $75.1193931-6
CPT CODE: $57.3193931-P
CPT CODE: $294.4793970-6
CPT CODE: $146.2693970-P
CPT CODE: $98.8193971-6
CPT CODE: $49.2793971-P
CPT CODE: $642.2793975-6
CPT CODE: $292.4993975-P
CPT CODE: $215.3993976-6
CPT CODE: $98.8193976-P
CPT CODE: $642.2793978-6
CPT CODE: $146.2693978-P
CPT CODE: $215.3993979-6
CPT CODE: $49.3993979-P
CPT CODE: $296.5493980-6
CPT CODE: $145.3793980-P
CPT CODE: $99.4993981-6
CPT CODE: $49.7593981-P
CPT CODE: $261.8493985-5
Page 58
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $40.2893985-P
CPT CODE: $221.5693985-TC
CPT CODE: $132.9193986-5
CPT CODE: $25.7993986-P
CPT CODE: $107.1293986-TC
CPT CODE: $74.4693990-6
CPT CODE: $171.3594002-6
CPT CODE: $171.3594002-A
CPT CODE: $171.3594002-N
CPT CODE: $58.0194003-6
CPT CODE: $58.0194003-A
CPT CODE: $58.0194003-N
CPT CODE: $171.3594004-6
CPT CODE: $171.3594004-A
CPT CODE: $171.3594004-N
CPT CODE: $104.7394010-6
CPT CODE: $104.7394010-A
CPT CODE: $104.7394010-N
CPT CODE: $57.3194010-P
CPT CODE: $135.0894011-6
CPT CODE: $208.4194012-6
CPT CODE: $44.3994013-6
CPT CODE: $264.1494014-6
CPT CODE: $69.7794015-6
CPT CODE: $56.4994016-6
CPT CODE: $136.3794060-6
CPT CODE: $136.3794060-A
CPT CODE: $136.3794060-N
CPT CODE: $84.9694060-P
CPT CODE: $306.3094070-6
CPT CODE: $306.3094070-A
CPT CODE: $306.3094070-N
CPT CODE: $71.1694070-P
CPT CODE: $61.2694150-6
CPT CODE: $61.2694150-A
CPT CODE: $61.2694150-N
CPT CODE: $73.1094200-6
CPT CODE: $73.1094200-A
CPT CODE: $73.1094200-N
CPT CODE: $55.3294250-6
CPT CODE: $55.3294250-A
CPT CODE: $55.3294250-N
CPT CODE: $63.2194375-6
CPT CODE: $63.2194375-A
CPT CODE: $63.2194375-N
CPT CODE: $25.6894375-P
CPT CODE: $102.7694400-6
CPT CODE: $102.7694400-A
CPT CODE: $102.7694400-N
CPT CODE: $82.3094610-6
CPT CODE: $82.3094610-A
CPT CODE: $82.3094610-N
CPT CODE: $151.7394617-6
CPT CODE: $48.8994617-Q
CPT CODE: $54.6294618-6
CPT CODE: $17.6094618-Q
CPT CODE: $265.7994621-6
CPT CODE: $49.3994640-6
CPT CODE: $49.3994640-A
CPT CODE: $49.3994640-N
CPT CODE: $316.2194642-6
CPT CODE: $316.2194642-A
CPT CODE: $316.2194642-N
CPT CODE: $44.5294644-6
CPT CODE: $44.5294644-A
CPT CODE: $44.5294644-N
CPT CODE: $14.8494644-P
CPT CODE: $17.5494645-6
CPT CODE: $17.5494645-A
CPT CODE: $17.5494645-N
CPT CODE: $5.4094645-P
CPT CODE: $211.4594660-6
CPT CODE: $211.4594660-A
CPT CODE: $211.4594660-N
CPT CODE: $39.5394664-6
CPT CODE: $39.5394664-A
CPT CODE: $39.5394664-N
CPT CODE: $55.3294667-6
CPT CODE: $55.3294667-A
CPT CODE: $55.3294667-N
CPT CODE: $34.9394669-6
CPT CODE: $69.1594680-6
CPT CODE: $69.1594680-A
CPT CODE: $69.1594680-N
CPT CODE: $124.5094681-6
CPT CODE: $124.5094681-A
CPT CODE: $124.5094681-N
CPT CODE: $69.1594690-6
CPT CODE: $69.1594690-A
CPT CODE: $69.1594690-N
CPT CODE: $86.5094726-6
CPT CODE: $20.8594726-P
CPT CODE: $68.3194727-6
CPT CODE: $20.8594727-P
CPT CODE: $68.3194728-6
CPT CODE: $20.8594728-P
CPT CODE: $85.6794729-6
CPT CODE: $65.2094750-6
CPT CODE: $65.2094750-A
CPT CODE: $65.2094750-N
CPT CODE: $582.9894772-6
CPT CODE: $223.3194772-P
CPT CODE: $60.8394780-6
CPT CODE: $23.6394781-6
CPT CODE: $7.1095000-6*
CPT CODE: $5.9295004-6*
CPT CODE: $89.1295017-6
CPT CODE: $30.8795018-6
CPT CODE: $16.2795024-6*
CPT CODE: $7.1095027-6*
CPT CODE: $21.8495028-6*
CPT CODE: $9.3395044-6
CPT CODE: $23.7095060-6
CPT CODE: $21.7695065-6
CPT CODE: $148.2095070-6
CPT CODE: $127.2595076-6
CPT CODE: $91.0295079-6
CPT CODE: $9.8895115-6
CPT CODE: $9.8895117-6
CPT CODE: $13.8195120-6
CPT CODE: $21.7695125-6
CPT CODE: $51.3895130-6
CPT CODE: $33.5995131-6
CPT CODE: $43.4795132-6
CPT CODE: $45.4595133-6
CPT CODE: $45.4595134-6
CPT CODE: $63.4695144-6
CPT CODE: $37.5495145-6
CPT CODE: $21.7695146-6
CPT CODE: $45.4595147-6
CPT CODE: $47.4495148-6
CPT CODE: $43.4795149-6
CPT CODE: $111.9995165-6
CPT CODE: $81.0495170-6
CPT CODE: $55.3295180-6
CPT CODE: $55.6995249-6
CPT CODE: $26.1895251-6
CPT CODE: $106.6295717-6
CPT CODE: $139.4595718-6
CPT CODE: $164.8995719-6
CPT CODE: $215.8995720-6
CPT CODE: $216.5895721-6
CPT CODE: $263.3695722-6
CPT CODE: $267.8995723-6
CPT CODE: $335.8695724-6
CPT CODE: $304.7995725-6
CPT CODE: $424.3695726-6
CPT CODE: $1,114.5395782-6
CPT CODE: $305.8995782-P
CPT CODE: $1,167.2595783-6
CPT CODE: $318.8895783-P
CPT CODE: $1,686.6495800-6
Page 59
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $85.5095800-P
CPT CODE: $2,847.3695801-6
CPT CODE: $76.2495801-P
CPT CODE: $800.3895805-6
CPT CODE: $317.2895805-P
CPT CODE: $927.4695806-6
CPT CODE: $1,269.1895807-6
CPT CODE: $503.9595807-P
CPT CODE: $1,269.1895808-6
CPT CODE: $503.9595808-P
CPT CODE: $1,269.1895810-6
CPT CODE: $503.9595810-P
CPT CODE: $1,030.5095811-6
CPT CODE: $484.8495811-P
CPT CODE: $241.4995812-6
CPT CODE: $241.4995813-6
CPT CODE: $163.9995816-6
CPT CODE: $245.0695819-6
CPT CODE: $134.3895819-P
CPT CODE: $239.1395822-6
CPT CODE: $179.8295824-6
CPT CODE: $274.6895829-P
CPT CODE: $1,679.7795830-6
CPT CODE: $4,045.3395830-A
CPT CODE: $4,045.3395830-N
CPT CODE: $114.3495836-6
CPT CODE: $69.1595851-6
CPT CODE: $37.5495852-6
CPT CODE: $112.6495857-6
CPT CODE: $262.8095860-6
CPT CODE: $167.9995860-P
CPT CODE: $345.8495861-6
CPT CODE: $233.1995861-P
CPT CODE: $484.1795863-6
CPT CODE: $345.8495863-P
CPT CODE: $632.3995864-6
CPT CODE: $365.5895864-P
CPT CODE: $261.7395865-6
CPT CODE: $135.0095865-P
CPT CODE: $188.7395866-6
CPT CODE: $96.4395866-P
CPT CODE: $116.6095867-6
CPT CODE: $165.9995868-6
CPT CODE: $152.1695869-6
CPT CODE: $143.6095870-6
CPT CODE: $152.1695872-6
CPT CODE: $96.8495872-P
CPT CODE: $104.6995873-6
CPT CODE: $53.7395873-P
CPT CODE: $104.6995874-6
CPT CODE: $53.7395874-P
CPT CODE: $49.6595885-6
CPT CODE: $16.0195885-P
CPT CODE: $78.9095886-6
CPT CODE: $42.6995886-P
CPT CODE: $70.0995887-6
CPT CODE: $33.5595887-P
CPT CODE: $106.7895905-6
CPT CODE: $4.0595905-P
CPT CODE: $102.0595907-6
CPT CODE: $58.0895907-P
CPT CODE: $126.0595908-6
CPT CODE: $72.8995908-P
CPT CODE: $150.9595909-6
CPT CODE: $87.1895909-P
CPT CODE: $198.8095910-6
CPT CODE: $116.4995910-P
CPT CODE: $240.6695911-6
CPT CODE: $145.2595911-P
CPT CODE: $282.5095912-6
CPT CODE: $174.5495912-P
CPT CODE: $327.4695913-6
CPT CODE: $206.7995913-P
CPT CODE: $54.9295921-6
CPT CODE: $18.8795921-P
CPT CODE: $54.9295922-6
CPT CODE: $18.8795922-P
CPT CODE: $54.9295923-6
CPT CODE: $18.8795923-P
CPT CODE: $102.1695924-6
CPT CODE: $58.1095924-P
CPT CODE: $189.7395925-6
CPT CODE: $63.6595926-6
CPT CODE: $63.6595927-6
CPT CODE: $103.1695928-6
CPT CODE: $103.1695928-P
CPT CODE: $103.1695929-6
CPT CODE: $103.1695929-P
CPT CODE: $281.1095930-6
CPT CODE: $114.9395930-P
CPT CODE: $284.5895933-6
CPT CODE: $114.9395933-P
CPT CODE: $138.3395937-6
CPT CODE: $221.5095938-6
CPT CODE: $73.6295938-P
CPT CODE: $409.5695939-6
CPT CODE: $147.7095939-P
CPT CODE: $37.5195940-6
CPT CODE: $233.1995955-6
CPT CODE: $233.1995955-A
CPT CODE: $233.1995955-N
CPT CODE: $225.2795958-P
CPT CODE: $258.8995961-6
CPT CODE: $102.6695961-P
CPT CODE: $258.8995962-6
CPT CODE: $102.6695962-P
CPT CODE: $96.3495970-6
CPT CODE: $96.3495971-6
CPT CODE: $96.3495972-6
CPT CODE: $96.3495973-6
CPT CODE: $42.2995976-6
CPT CODE: $56.4395977-6
CPT CODE: $53.1995983-6
CPT CODE: $46.6795984-6
CPT CODE: $72.1795990-6
CPT CODE: $72.1795990-Q
CPT CODE: $88.5395991-6
CPT CODE: $88.5395991-Q
CPT CODE: $258.6395992-6
CPT CODE: $206.9296105-6
CPT CODE: $206.9296105-C
CPT CODE: $180.9396110-6
CPT CODE: $180.9396110-C
CPT CODE: $136.2896112-6
CPT CODE: $62.1696113-6
CPT CODE: $81.2896116-6
CPT CODE: $81.2896116-C
CPT CODE: $84.1596121-6
CPT CODE: $166.8796125-6
CPT CODE: $166.8796125-C
CPT CODE: $5.4196127-6
CPT CODE: $118.9396130-6
CPT CODE: $90.6896131-6
CPT CODE: $116.9896132-6
CPT CODE: $89.6396133-6
CPT CODE: $26.6296136-6
CPT CODE: $21.0996137-6
CPT CODE: $37.9496139-6
CPT CODE: $1.9596146-6
CPT CODE: $93.7696156-6
CPT CODE: $64.0396158-6
CPT CODE: $22.0796159-6
CPT CODE: $12.9896160-6
CPT CODE: $4.7696161-6
CPT CODE: $9.3396164-6
CPT CODE: $4.1796165-6
CPT CODE: $68.4796167-6
CPT CODE: $24.3396168-6
CPT CODE: $29.0396170-6
CPT CODE: $14.5196171-6
CPT CODE: $76.3096360-6
CPT CODE: $24.5796361-6
Page 60
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $93.1196365-6
CPT CODE: $32.3396366-6
CPT CODE: $51.7396367-6
CPT CODE: $31.0496368-6
CPT CODE: $198.5096369-6
CPT CODE: $20.7096370-6
CPT CODE: $91.8196371-6
CPT CODE: $21.9896372-6
CPT CODE: $21.9896372-A
CPT CODE: $21.9896372-C
CPT CODE: $21.9896372-N
CPT CODE: $69.8396374-6
CPT CODE: $32.3396375-6
CPT CODE: $19.5396377-6
CPT CODE: $67.5196401-6
CPT CODE: $67.5196401-Q
CPT CODE: $46.8396402-6
CPT CODE: $46.8396402-Q
CPT CODE: $65.3296405-Q
CPT CODE: $143.7196406-Q
CPT CODE: $157.0496409-6
CPT CODE: $157.0496409-Q
CPT CODE: $92.3196411-6
CPT CODE: $92.3196411-Q
CPT CODE: $221.7996413-6
CPT CODE: $221.7996413-Q
CPT CODE: $50.9896415-6
CPT CODE: $50.9896415-Q
CPT CODE: $238.3296416-6
CPT CODE: $238.3296416-Q
CPT CODE: $108.8496417-6
CPT CODE: $108.8496417-Q
CPT CODE: $96.8496420-Q
CPT CODE: $156.1296422-Q
CPT CODE: $45.4596423-Q
CPT CODE: $106.7296425-Q
CPT CODE: $272.7496440-Q
CPT CODE: $462.5896446-Q
CPT CODE: $272.7496450-Q
CPT CODE: $197.0096521-Q
CPT CODE: $141.8996522-6
CPT CODE: $141.8996522-Q
CPT CODE: $35.8296523-6
CPT CODE: $35.8296523-Q
CPT CODE: $95.6396542-Q
CPT CODE: $194.6296573-Q
CPT CODE: $252.0296574-6
CPT CODE: $34.0596900-6
CPT CODE: $56.1596910-6
CPT CODE: $57.4696912-6
CPT CODE: $180.9396913-6
CPT CODE: $196.9896920-6
CPT CODE: $212.0296921-6
CPT CODE: $281.1896922-6
CPT CODE: $50.7497763-6
CPT CODE: $48.3698925-6
CPT CODE: $57.7298926-6
CPT CODE: $72.8098927-6
CPT CODE: $102.6698928-6
CPT CODE: $147.4898929-6
CPT CODE: $136.3799002-6
CPT CODE: $20.6699051-6
CPT CODE: $282.6099078-6
CPT CODE: $282.6099078-A
CPT CODE: $282.6099078-N
CPT CODE: $83.5499080-6
CPT CODE: $26.1599151-6
CPT CODE: $13.6999152-6
CPT CODE: $11.2199153-6
CPT CODE: $102.6999155-6
CPT CODE: $84.2499156-6
CPT CODE: $63.9199157-6
CPT CODE: $192.4799170-6
CPT CODE: $135.7099175-6
CPT CODE: $135.7099175-A
CPT CODE: $135.7099175-B
CPT CODE: $135.7099175-C
CPT CODE: $135.7099175-N
CPT CODE: $135.7099175-R
CPT CODE: $35.4299177-6
CPT CODE: $76.5499183-6
CPT CODE: $76.5499183-A
CPT CODE: $260.1199184-6
CPT CODE: $23.2299188-6
CPT CODE: $69.1599195-6
CPT CODE: $69.1599195-A
CPT CODE: $66.8499201-6
CPT CODE: $66.8499201-A
CPT CODE: $72.2699201-C
CPT CODE: $66.8499201-N
CPT CODE: $66.8499201-Q
CPT CODE: $83.0599202-6
CPT CODE: $83.0599202-A
CPT CODE: $91.0499202-C
CPT CODE: $83.0599202-N
CPT CODE: $83.0599202-Q
CPT CODE: $117.4899203-6
CPT CODE: $117.4899203-A
CPT CODE: $124.7199203-C
CPT CODE: $117.4899203-N
CPT CODE: $117.4899203-Q
CPT CODE: $168.5299204-6
CPT CODE: $168.5299204-A
CPT CODE: $182.0499204-C
CPT CODE: $168.5299204-N
CPT CODE: $168.5299204-Q
CPT CODE: $251.2099205-6
CPT CODE: $251.2099205-A
CPT CODE: $251.2099205-C
CPT CODE: $251.2099205-N
CPT CODE: $251.2099205-Q
CPT CODE: $46.5899211-6
CPT CODE: $46.5899211-A
CPT CODE: $46.5899211-C
CPT CODE: $46.5899211-N
CPT CODE: $46.5899211-Q
CPT CODE: $62.7899212-6
CPT CODE: $62.7899212-A
CPT CODE: $62.7899212-C
CPT CODE: $62.7899212-N
CPT CODE: $62.7899212-Q
CPT CODE: $72.9399213-6
CPT CODE: $72.9399213-A
CPT CODE: $72.9399213-C
CPT CODE: $72.9399213-N
CPT CODE: $72.9399213-Q
CPT CODE: $95.2099214-6
CPT CODE: $95.2099214-A
CPT CODE: $95.2099214-C
CPT CODE: $95.2099214-N
CPT CODE: $95.2099214-Q
CPT CODE: $139.7499215-6
CPT CODE: $139.7499215-A
CPT CODE: $139.7499215-C
CPT CODE: $139.7499215-N
CPT CODE: $139.7499215-Q
CPT CODE: $110.1399217-6
CPT CODE: $130.0999218-6
CPT CODE: $130.0999218-A
CPT CODE: $166.4499219-6
CPT CODE: $166.4499219-A
CPT CODE: $244.8799220-6
CPT CODE: $244.8799220-A
CPT CODE: $130.4299221-6
CPT CODE: $130.4299221-B
CPT CODE: $130.4299221-C
CPT CODE: $130.4299221-N
CPT CODE: $165.9999222-6
CPT CODE: $165.9999222-B
CPT CODE: $165.9999222-C
CPT CODE: $165.9999222-N
CPT CODE: $245.0699223-6
Page 61
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $245.0699223-B
CPT CODE: $245.0699223-C
CPT CODE: $245.0699223-N
CPT CODE: $36.0299224-6
CPT CODE: $36.0299224-A
CPT CODE: $36.0299224-C
CPT CODE: $36.0299224-N
CPT CODE: $36.0299224-Q
CPT CODE: $36.0299224-X
CPT CODE: $64.4699225-6
CPT CODE: $64.4699225-A
CPT CODE: $64.4699225-C
CPT CODE: $64.4699225-N
CPT CODE: $64.4699225-Q
CPT CODE: $64.4699225-X
CPT CODE: $96.0699226-6
CPT CODE: $96.0699226-A
CPT CODE: $96.0699226-C
CPT CODE: $96.0699226-N
CPT CODE: $96.0699226-Q
CPT CODE: $96.0699226-X
CPT CODE: $69.1599231-6
CPT CODE: $69.1599231-B
CPT CODE: $69.1599231-C
CPT CODE: $69.1599231-E
CPT CODE: $69.1599231-N
CPT CODE: $88.9199232-6
CPT CODE: $88.9199232-B
CPT CODE: $88.9199232-C
CPT CODE: $88.9199232-E
CPT CODE: $88.9199232-N
CPT CODE: $118.5999233-6
CPT CODE: $118.5999233-B
CPT CODE: $118.5999233-C
CPT CODE: $118.5999233-E
CPT CODE: $118.5999233-N
CPT CODE: $195.9699234-6
CPT CODE: $195.9699234-A
CPT CODE: $195.9699234-C
CPT CODE: $195.9699234-N
CPT CODE: $195.9699234-Q
CPT CODE: $224.7099235-6
CPT CODE: $224.7099235-A
CPT CODE: $224.7099235-C
CPT CODE: $224.7099235-N
CPT CODE: $224.7099235-Q
CPT CODE: $295.6599236-6
CPT CODE: $295.6599236-A
CPT CODE: $295.6599236-C
CPT CODE: $295.6599236-N
CPT CODE: $295.6599236-Q
CPT CODE: $108.6999238-6
CPT CODE: $108.6999238-B
CPT CODE: $108.6999238-C
CPT CODE: $108.6999238-E
CPT CODE: $108.6999238-N
CPT CODE: $111.3799239-6
CPT CODE: $111.3799239-C
CPT CODE: $111.3799239-D
CPT CODE: $111.3799239-E
CPT CODE: $111.3799239-N
CPT CODE: $133.7299241-9
CPT CODE: $133.7299241-A
CPT CODE: $133.7299241-N
CPT CODE: $166.0899242-9
CPT CODE: $166.0899242-A
CPT CODE: $166.0899242-N
CPT CODE: $192.4199243-9
CPT CODE: $192.4199243-A
CPT CODE: $192.4199243-N
CPT CODE: $251.2099244-9
CPT CODE: $251.2099244-A
CPT CODE: $251.2099244-N
CPT CODE: $277.5099245-9
CPT CODE: $277.5099245-A
CPT CODE: $277.5099245-N
CPT CODE: $130.4299251-9
CPT CODE: $130.4299251-A
CPT CODE: $130.4299251-N
CPT CODE: $162.0399252-9
CPT CODE: $162.0399252-A
CPT CODE: $162.0399252-N
CPT CODE: $187.7399253-9
CPT CODE: $187.7399253-A
CPT CODE: $187.7399253-N
CPT CODE: $245.0699254-9
CPT CODE: $245.0699254-A
CPT CODE: $245.0699254-N
CPT CODE: $280.6399255-9
CPT CODE: $280.6399255-A
CPT CODE: $280.6399255-N
CPT CODE: $63.2199281-6
CPT CODE: $63.2199281-A
CPT CODE: $63.2199281-C
CPT CODE: $63.2199281-N
CPT CODE: $84.9699282-6
CPT CODE: $84.9699282-A
CPT CODE: $84.9699282-C
CPT CODE: $84.9699282-N
CPT CODE: $104.7399283-6
CPT CODE: $104.7399283-A
CPT CODE: $104.7399283-C
CPT CODE: $104.7399283-N
CPT CODE: $128.4499284-6
CPT CODE: $128.4499284-C
CPT CODE: $128.4499284-N
CPT CODE: $191.6699285-6
CPT CODE: $191.6699285-A
CPT CODE: $191.6699285-C
CPT CODE: $191.6699285-N
CPT CODE: $251.0099291-6
CPT CODE: $251.0099291-A
CPT CODE: $251.0099291-B
CPT CODE: $251.0099291-C
CPT CODE: $251.0099291-N
CPT CODE: $187.7399292-6
CPT CODE: $187.7399292-A
CPT CODE: $187.7399292-B
CPT CODE: $187.7399292-C
CPT CODE: $187.7399292-N
CPT CODE: $93.6899304-6
CPT CODE: $93.6899304-A
CPT CODE: $93.6899304-C
CPT CODE: $93.6899304-N
CPT CODE: $125.3699305-6
CPT CODE: $125.3699305-A
CPT CODE: $125.3699305-C
CPT CODE: $125.3699305-N
CPT CODE: $157.0499306-6
CPT CODE: $157.0499306-A
CPT CODE: $157.0499306-C
CPT CODE: $157.0499306-N
CPT CODE: $41.3399307-6
CPT CODE: $41.3399307-A
CPT CODE: $41.3399307-C
CPT CODE: $41.3399307-N
CPT CODE: $68.8899308-6
CPT CODE: $68.8899308-A
CPT CODE: $68.8899308-C
CPT CODE: $68.8899308-N
CPT CODE: $96.4399309-6
CPT CODE: $96.4399309-A
CPT CODE: $96.4399309-C
CPT CODE: $96.4399309-N
CPT CODE: $119.8599310-6
CPT CODE: $119.8599310-A
CPT CODE: $119.8599310-C
CPT CODE: $119.8599310-N
CPT CODE: $96.2999315-6
CPT CODE: $96.2999315-A
CPT CODE: $96.2999315-B
CPT CODE: $96.2999315-C
Page 62
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $96.2999315-N
CPT CODE: $96.2999316-6
CPT CODE: $96.2999316-A
CPT CODE: $96.2999316-B
CPT CODE: $96.2999316-C
CPT CODE: $96.2999316-N
CPT CODE: $79.9099318-6
CPT CODE: $79.9099318-A
CPT CODE: $79.9099318-C
CPT CODE: $79.9099318-N
CPT CODE: $67.5199324-6
CPT CODE: $67.5199324-A
CPT CODE: $67.5199324-C
CPT CODE: $67.5199324-N
CPT CODE: $100.5799325-6
CPT CODE: $100.5799325-A
CPT CODE: $100.5799325-C
CPT CODE: $100.5799325-N
CPT CODE: $147.4099326-6
CPT CODE: $147.4099326-A
CPT CODE: $147.4099326-C
CPT CODE: $147.4099326-N
CPT CODE: $197.0099327-6
CPT CODE: $197.0099327-A
CPT CODE: $197.0099327-C
CPT CODE: $197.0099327-N
CPT CODE: $246.5899328-6
CPT CODE: $246.5899328-A
CPT CODE: $246.5899328-C
CPT CODE: $246.5899328-N
CPT CODE: $44.0899334-6
CPT CODE: $44.0899334-A
CPT CODE: $44.0899334-C
CPT CODE: $44.0899334-N
CPT CODE: $73.0199335-6
CPT CODE: $73.0199335-A
CPT CODE: $73.0199335-C
CPT CODE: $73.0199335-N
CPT CODE: $115.7199336-6
CPT CODE: $115.7199336-A
CPT CODE: $115.7199336-C
CPT CODE: $115.7199336-N
CPT CODE: $173.5799337-6
CPT CODE: $173.5799337-A
CPT CODE: $173.5799337-C
CPT CODE: $173.5799337-N
CPT CODE: $96.8499341-6
CPT CODE: $96.8499341-A
CPT CODE: $96.8499341-C
CPT CODE: $96.8499341-N
CPT CODE: $110.6799342-6
CPT CODE: $110.6799342-A
CPT CODE: $110.6799342-C
CPT CODE: $110.6799342-N
CPT CODE: $162.0399343-6
CPT CODE: $162.0399343-A
CPT CODE: $162.0399343-C
CPT CODE: $162.0399343-N
CPT CODE: $231.4499344-6
CPT CODE: $231.4499344-A
CPT CODE: $231.4499344-C
CPT CODE: $231.4499344-N
CPT CODE: $288.8899345-6
CPT CODE: $288.8899345-A
CPT CODE: $288.8899345-C
CPT CODE: $288.8899345-N
CPT CODE: $65.8999347-6
CPT CODE: $65.8999347-A
CPT CODE: $65.8999347-C
CPT CODE: $65.8999347-N
CPT CODE: $89.5399348-6
CPT CODE: $89.5399348-A
CPT CODE: $89.5399348-C
CPT CODE: $89.5399348-N
CPT CODE: $119.9699349-6
CPT CODE: $119.9699349-A
CPT CODE: $119.9699349-C
CPT CODE: $119.9699349-N
CPT CODE: $143.6099350-6
CPT CODE: $143.6099350-A
CPT CODE: $143.6099350-C
CPT CODE: $143.6099350-N
CPT CODE: $259.4499354-6
CPT CODE: $259.4499354-A
CPT CODE: $259.4499354-C
CPT CODE: $259.4499354-E
CPT CODE: $259.4499354-N
CPT CODE: $125.0799355-A
CPT CODE: $125.0799355-C
CPT CODE: $125.0799355-E
CPT CODE: $125.0799355-N
CPT CODE: $259.4499356-6
CPT CODE: $259.4499356-E
CPT CODE: $125.0799357-6
CPT CODE: $334.1299358-6
CPT CODE: $167.0699359-6
CPT CODE: $83.5499367-6
CPT CODE: $83.5499368-6
CPT CODE: $59.2899381-6
CPT CODE: $61.2699382-6
CPT CODE: $68.5499383-6
CPT CODE: $57.3199391-6
CPT CODE: $63.2199392-6
CPT CODE: $63.2199393-6
CPT CODE: $73.1099394-6
CPT CODE: $9.1499415-6
CPT CODE: $0.6299416-6
CPT CODE: $161.6599460-6
CPT CODE: $81.4799462-6
CPT CODE: $243.1299463-6
CPT CODE: $192.6899464-6
CPT CODE: $178.4699465-6
CPT CODE: $178.4699465-A
CPT CODE: $178.4699465-N
CPT CODE: $228.9099466-6
CPT CODE: $228.9099466-A
CPT CODE: $228.9099466-C
CPT CODE: $228.9099466-N
CPT CODE: $138.3799467-6
CPT CODE: $138.3799467-A
CPT CODE: $138.3799467-C
CPT CODE: $138.3799467-N
CPT CODE: $600.0499468-6
CPT CODE: $455.2099469-6
CPT CODE: $600.0499471-6
CPT CODE: $437.1099472-6
CPT CODE: $10.6299473-6
CPT CODE: $9.2299474-6
CPT CODE: $413.6599475-6
CPT CODE: $362.4199476-6
CPT CODE: $388.0899477-6
CPT CODE: $168.1199478-6
CPT CODE: $155.1899479-6
CPT CODE: $148.7199480-6
CPT CODE: $188.1399483-6
CPT CODE: $34.3299484-C
CPT CODE: $50.1699484-NF
CPT CODE: $73.1899485-6
CPT CODE: $39.6199486-6
CPT CODE: $45.2299490-6
CPT CODE: $87.0999491-6
CPT CODE: $94.7499492-C
CPT CODE: $165.6799492-NF
CPT CODE: $85.6599493-C
CPT CODE: $132.8299493-NF
CPT CODE: $45.7299494-C
CPT CODE: $68.7799494-NF
CPT CODE: $135.8699495-6
CPT CODE: $191.6099496-6
CPT CODE: $1,194.34A9507-G
CPT CODE: $324.65A9590-6
CPT CODE: $1,093.00A9600-6
Page 63
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE: $1,093.00A9600-E
CPT CODE: $1,093.00A9600-Q
CPT CODE: $185.83G0104-2
CPT CODE: $868.31G0105-2
CPT CODE: $250.02G0106-P
CPT CODE: $60.17G0117-6
CPT CODE: $60.17G0117-A
CPT CODE: $60.17G0117-M
CPT CODE: $60.17G0117-N
CPT CODE: $60.17G0117-P
CPT CODE: $949.42G0120-P
CPT CODE: $868.31G0121-2
CPT CODE: $64.18G0122-P
CPT CODE: $340.53G0130-5
CPT CODE: $111.30G0130-P
CPT CODE: $14.14G0141-8
CPT CODE: $30.74G0143-8
CPT CODE: $30.74G0144-8
CPT CODE: $30.74G0145-8
CPT CODE: $14.14G0147-8
CPT CODE: $14.14G0148-8
CPT CODE: $107.99G0202-5
CPT CODE: $50.92G0202-P
CPT CODE: $107.99G0204-5
CPT CODE: $50.92G0204-P
CPT CODE: $2,422.13G0219-5
CPT CODE: $362.55G0219-P
CPT CODE: $75.18G0245-6
CPT CODE: $52.63G0246-6
CPT CODE: $75.18G0247-6
CPT CODE: $1,771.30G0252-6
CPT CODE: $353.35G0252-P
CPT CODE: $204.49G0257-6
CPT CODE: $82.70G0259-2
CPT CODE: $40.59G0268-2
CPT CODE: $48.39G0277-6
CPT CODE: $608.97G0278-5
CPT CODE: $193.97G0278-P
CPT CODE: $63.49G0279-5
CPT CODE: $35.76G0279-P
CPT CODE: $34.59G0283-D
CPT CODE: $34.59G0283-N
CPT CODE: $500.72G0288-5
CPT CODE: $112.78G0288-P
CPT CODE: $1,774.31G0289-2
CPT CODE: $105.33G0297-5
CPT CODE: $29.78G0297-P
CPT CODE: $19.18G0306-8
CPT CODE: $5.75G0306-P
CPT CODE: $9.52G0307-8
CPT CODE: $3.31G0307-P
CPT CODE: $28.08G0328-6
CPT CODE: $37.20G0372-6
CPT CODE: $46.47G0406-6
CPT CODE: $46.47G0406-9
CPT CODE: $46.47G0406-A
CPT CODE: $46.47G0406-N
CPT CODE: $83.48G0407-6
CPT CODE: $83.48G0407-9
CPT CODE: $83.48G0407-A
CPT CODE: $83.48G0407-N
CPT CODE: $119.57G0408-6
CPT CODE: $119.57G0408-9
CPT CODE: $119.57G0408-A
CPT CODE: $119.57G0408-N
CPT CODE: $10.82G0409-6
CPT CODE: $1,762.62G0412-2
CPT CODE: $1,196.20G0413-2
CPT CODE: $2,537.24G0414-2
CPT CODE: $2,631.65G0415-2
CPT CODE: $747.61G0416-8
CPT CODE: $233.19G0416-P
CPT CODE: $151.80G0420-6
CPT CODE: $151.80G0420-X
CPT CODE: $34.09G0421-6
CPT CODE: $34.09G0421-C
CPT CODE: $34.09G0421-X
CPT CODE: $86.20G0422-6
CPT CODE: $86.20G0423-6
CPT CODE: $40.52G0424-6
CPT CODE: $140.22G0425-6
CPT CODE: $140.22G0425-9
CPT CODE: $140.22G0425-A
CPT CODE: $140.22G0425-N
CPT CODE: $190.40G0426-6
CPT CODE: $190.40G0426-9
CPT CODE: $190.40G0426-A
CPT CODE: $190.40G0426-N
CPT CODE: $279.17G0427-6
CPT CODE: $279.17G0427-9
CPT CODE: $279.17G0427-A
CPT CODE: $279.17G0427-N
CPT CODE: $131.45G0438-6
CPT CODE: $120.07G0439-6
CPT CODE: $23.26G0452-P
CPT CODE: $31.06G0453-6
CPT CODE: $141.27G0455-6
CPT CODE: $13.65G0473-6
CPT CODE: $16.26G0475-8
CPT CODE: $26.72G0476-8
CPT CODE: $69.63G0480-8
CPT CODE: $69.63G0481-8
CPT CODE: $69.63G0482-8
CPT CODE: $69.63G0483-8
CPT CODE: $6.05G0500-6
CPT CODE: $113.80G0516-6
CPT CODE: $129.77G0517-6
CPT CODE: $210.11G0518-6
CPT CODE: $68.28G0659-8
CPT CODE: $17.71G2011-X
CPT CODE: $36.93G2066-G
CPT CODE: $167.22G6001-6
CPT CODE: $75.49G6001-P
CPT CODE: $171.87G6002-6
CPT CODE: $51.10G6002-P
CPT CODE: $197.42G6003-6
CPT CODE: $197.42G6004-6
CPT CODE: $197.42G6005-6
CPT CODE: $197.42G6006-6
CPT CODE: $278.36G6007-6
CPT CODE: $207.87G6008-6
CPT CODE: $207.87G6009-6
CPT CODE: $207.87G6010-6
CPT CODE: $297.70G6011-6
CPT CODE: $246.26G6012-6
CPT CODE: $277.58G6013-6
CPT CODE: $277.20G6014-6
CPT CODE: $1,007.99G6015-6
CPT CODE: $1,007.99G6016-6
CPT CODE:
J$50.42J0120-6
CPT CODE:
J$50.42J0120-Q
CPT CODE:
J$25.81J0129-6
CPT CODE:
J$25.81J0129-Q
CPT CODE:
J$988.37J0130-6
CPT CODE:
J$0.49J0133-6
CPT CODE:
J$0.49J0133-Q
CPT CODE:
J$0.95J0153-6
CPT CODE:
J$0.11J0171-6
CPT CODE:
J$0.11J0171-Q
CPT CODE:
J$1,158.00J0178-6
CPT CODE:
J$331.45J0179-6
CPT CODE:
J$173.84J0180-6
CPT CODE:
J$173.84J0180-Q
CPT CODE:
J$2.72J0185-6
CPT CODE:
J$20.54J0190-6
CPT CODE:
J$20.54J0190-Q
CPT CODE:
J$29.92J0200-6
CPT CODE:
J$29.92J0200-Q
CPT CODE:
J$2,044.59J0202-6
CPT CODE:
J$72.80J0205-6
CPT CODE:
J$72.80J0205-Q
CPT CODE:
J$601.41J0207-6
Page 64
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE:
J$601.41J0207-Q
CPT CODE:
J$20.54J0210-6
CPT CODE:
J$20.54J0210-Q
CPT CODE:
J$41.61J0215-6
CPT CODE:
J$41.61J0215-Q
CPT CODE:
J$161.05J0220-6
CPT CODE:
J$161.05J0220-Q
CPT CODE:
J$190.65J0256-6
CPT CODE:
J$190.65J0256-Q
CPT CODE:
J$34.89J0275-6
CPT CODE:
J$4.45J0278-6
CPT CODE:
J$4.45J0278-Q
CPT CODE:
J$20.54J0280-6
CPT CODE:
J$20.54J0280-Q
CPT CODE:
J$28.04J0282-6
CPT CODE:
J$28.04J0282-Q
CPT CODE:
J$54.83J0285-6
CPT CODE:
J$54.83J0285-Q
CPT CODE:
J$34.59J0287-6
CPT CODE:
J$34.59J0287-Q
CPT CODE:
J$24.05J0288-6
CPT CODE:
J$24.05J0288-Q
CPT CODE:
J$56.69J0289-6
CPT CODE:
J$56.69J0289-Q
CPT CODE:
J$20.54J0290-6
CPT CODE:
J$20.54J0290-Q
CPT CODE:
J$20.54J0300-6
CPT CODE:
J$20.54J0300-Q
CPT CODE:
J$20.54J0330-6
CPT CODE:
J$20.54J0330-Q
CPT CODE:
J$3.04J0348-6
CPT CODE:
J$3.04J0348-Q
CPT CODE:
J$20.54J0360-6
CPT CODE:
J$20.54J0360-Q
CPT CODE:
J$4.92J0364-6
CPT CODE:
J$4.92J0364-Q
CPT CODE:
J$4.09J0365-6
CPT CODE:
J$4.09J0365-Q
CPT CODE:
J$20.54J0380-6
CPT CODE:
J$20.54J0380-Q
CPT CODE:
J$42.60J0390-6
CPT CODE:
J$42.60J0390-Q
CPT CODE:
J$352.15J0395-6
CPT CODE:
J$352.15J0395-Q
CPT CODE:
J$0.45J0400-6
CPT CODE:
J$0.45J0400-Q
CPT CODE:
J$4.54J0401-6
CPT CODE:
J$38.33J0456-6
CPT CODE:
J$38.33J0456-Q
CPT CODE:
J$0.02J0461-6
CPT CODE:
J$0.02J0461-Q
CPT CODE:
J$65.32J0470-6
CPT CODE:
J$65.32J0470-Q
CPT CODE:
J$403.77J0475-6
CPT CODE:
J$403.77J0475-Q
CPT CODE:
J$142.85J0476-6
CPT CODE:
J$142.85J0476-Q
CPT CODE:
J$2,561.91J0480-6
CPT CODE:
J$2,561.91J0480-Q
CPT CODE:
J$4.61J0485-6
CPT CODE:
J$20.54J0500-6
CPT CODE:
J$20.54J0500-Q
CPT CODE:
J$20.54J0515-6
CPT CODE:
J$20.54J0515-Q
CPT CODE:
J$174.20J0517-6
CPT CODE:
J$20.54J0520-6
CPT CODE:
J$20.54J0520-Q
CPT CODE:
J$5.05J0558-6
CPT CODE:
J$5.05J0558-Q
CPT CODE:
J$7.00J0561-6
CPT CODE:
J$7.00J0561-Q
CPT CODE:
J$45.27J0565-6
CPT CODE:
J$98.98J0567-6
CPT CODE:
J$20.31J0570-6
CPT CODE:
J$2.70J0583-6
CPT CODE:
J$2.70J0583-Q
CPT CODE:
J$373.91J0584-6
CPT CODE:
J$6.94J0585-6
CPT CODE:
J$6.94J0585-Q
CPT CODE:
J$9.09J0586-6
CPT CODE:
J$9.09J0586-Q
CPT CODE:
J$14.26J0587-6
CPT CODE:
J$14.26J0587-Q
CPT CODE:
J$1.50J0592-6
CPT CODE:
J$1.50J0592-Q
CPT CODE:
J$13.44J0594-Q
CPT CODE:
J$11.94J0595-6
CPT CODE:
J$11.94J0595-Q
CPT CODE:
J$38.41J0596-6
CPT CODE:
J$46.07J0597-6
CPT CODE:
J$46.07J0597-Q
CPT CODE:
J$54.77J0598-6
CPT CODE:
J$54.77J0598-Q
CPT CODE:
J$10.34J0599-6
CPT CODE:
J$74.07J0600-6
CPT CODE:
J$74.07J0600-Q
CPT CODE:
J$3.67J0606-6
CPT CODE:
J$63.46J0610-6
CPT CODE:
J$63.46J0610-Q
CPT CODE:
J$20.54J0620-6
CPT CODE:
J$20.54J0620-Q
CPT CODE:
J$93.34J0630-6
CPT CODE:
J$93.34J0630-Q
CPT CODE:
J$21.87J0636-6
CPT CODE:
J$21.87J0636-Q
CPT CODE:
J$49.82J0637-6
CPT CODE:
J$49.82J0637-Q
CPT CODE:
J$113.96J0638-6
CPT CODE:
J$113.96J0638-Q
CPT CODE:
J$44.79J0640-Q
CPT CODE:
J$1.70J0641-6
CPT CODE:
J$1.70J0641-Q
CPT CODE:
J$20.54J0670-6
CPT CODE:
J$20.54J0670-Q
CPT CODE:
J$20.54J0690-6
CPT CODE:
J$20.54J0690-Q
CPT CODE:
J$12.34J0692-6
CPT CODE:
J$12.34J0692-Q
CPT CODE:
J$20.54J0694-6
CPT CODE:
J$2,554.24J0695-6
CPT CODE:
J$20.54J0696-6
CPT CODE:
J$20.54J0696-Q
CPT CODE:
J$20.54J0697-6
CPT CODE:
J$20.54J0697-Q
CPT CODE:
J$20.54J0698-6
CPT CODE:
J$20.54J0698-Q
CPT CODE:
J$7.51J0702-6
CPT CODE:
J$7.51J0702-Q
CPT CODE:
J$4.96J0706-6
CPT CODE:
J$4.96J0706-Q
CPT CODE:
J$20.54J0710-6
CPT CODE:
J$20.54J0710-Q
CPT CODE:
J$350.83J0714-6
CPT CODE:
J$6.30J0717-6
CPT CODE:
J$5.03J0718-6
CPT CODE:
J$5.03J0718-Q
CPT CODE:
J$20.54J0720-6
CPT CODE:
J$20.54J0720-Q
CPT CODE:
J$20.54J0725-6
CPT CODE:
J$20.54J0725-Q
CPT CODE:
J$96.29J0735-6
CPT CODE:
J$96.29J0735-Q
CPT CODE:
J$1,314.31J0740-3
CPT CODE:
J$1,351.46J0740-6
CPT CODE:
J$1,351.46J0740-Q
CPT CODE:
J$20.54J0743-6
CPT CODE:
J$20.54J0743-Q
CPT CODE:
J$24.08J0744-6
CPT CODE:
J$24.08J0744-Q
CPT CODE:
J$20.54J0745-6
CPT CODE:
J$20.54J0745-Q
CPT CODE:
J$69.07J0770-6
Page 65
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE:
J$69.07J0770-Q
CPT CODE:
J$49.29J0775-6
CPT CODE:
J$49.29J0775-Q
CPT CODE:
J$20.54J0780-6
CPT CODE:
J$20.54J0780-Q
CPT CODE:
J$7.12J0795-6
CPT CODE:
J$7.12J0795-Q
CPT CODE:
J$48.55J0800-6
CPT CODE:
J$48.55J0800-Q
CPT CODE:
J$148.07J0834-6
CPT CODE:
J$148.07J0834-Q
CPT CODE:
J$1,341.66J0841-6
CPT CODE:
J$1,834.13J0875-6
CPT CODE:
J$0.49J0878-6
CPT CODE:
J$0.49J0878-Q
CPT CODE:
J$6.35J0881-6
CPT CODE:
J$6.35J0881-Q
CPT CODE:
J$6.35J0882-6
CPT CODE:
J$6.35J0882-Q
CPT CODE:
J$5.14J0883-6
CPT CODE:
J$5.14J0884-6
CPT CODE:
J$17.23J0885-6
CPT CODE:
J$17.23J0885-Q
CPT CODE:
J$13.53J0890-6
CPT CODE:
J$34.40J0894-Q
CPT CODE:
J$20.54J0895-6
CPT CODE:
J$20.54J0945-6
CPT CODE:
J$20.54J0945-Q
CPT CODE:
J$20.54J1000-6
CPT CODE:
J$20.54J1000-Q
CPT CODE:
J$20.54J1020-6
CPT CODE:
J$20.54J1020-Q
CPT CODE:
J$20.54J1030-6
CPT CODE:
J$20.54J1030-Q
CPT CODE:
J$20.54J1040-6
CPT CODE:
J$20.54J1040-Q
CPT CODE:
J$0.41J1050-6
CPT CODE:
J$0.03J1071-6
CPT CODE:
J$1.50J1094-6
CPT CODE:
J$1.50J1094-Q
CPT CODE:
J$1.15J1095-6
CPT CODE:
J$20.54J1100-6
CPT CODE:
J$20.54J1100-Q
CPT CODE:
J$20.54J1110-6
CPT CODE:
J$20.54J1110-Q
CPT CODE:
J$77.78J1120-6
CPT CODE:
J$77.78J1120-Q
CPT CODE:
J$0.25J1130-6
CPT CODE:
J$20.54J1160-6
CPT CODE:
J$20.54J1160-Q
CPT CODE:
J$826.52J1162-6
CPT CODE:
J$826.52J1162-Q
CPT CODE:
J$20.54J1165-6
CPT CODE:
J$20.54J1165-Q
CPT CODE:
J$20.54J1170-6
CPT CODE:
J$20.54J1170-Q
CPT CODE:
J$20.54J1180-6
CPT CODE:
J$20.54J1180-Q
CPT CODE:
J$20.54J1200-6
CPT CODE:
J$20.54J1200-Q
CPT CODE:
J$20.54J1205-6
CPT CODE:
J$20.54J1205-Q
CPT CODE:
J$87.72J1212-6
CPT CODE:
J$87.72J1212-Q
CPT CODE:
J$20.54J1230-6
CPT CODE:
J$20.54J1230-Q
CPT CODE:
J$20.54J1240-6
CPT CODE:
J$20.54J1240-Q
CPT CODE:
J$61.11J1245-6
CPT CODE:
J$3.31J1260-6
CPT CODE:
J$3.31J1260-Q
CPT CODE:
J$1.06J1267-6
CPT CODE:
J$1.06J1267-Q
CPT CODE:
J$17.06J1270-6
CPT CODE:
J$17.06J1270-Q
CPT CODE:
J$353.68J1290-6
CPT CODE:
J$353.68J1290-Q
CPT CODE:
J$242.15J1300-6
CPT CODE:
J$242.15J1300-Q
CPT CODE:
J$20.30J1301-6
CPT CODE:
J$20.54J1320-6
CPT CODE:
J$20.54J1320-Q
CPT CODE:
J$262.94J1322-6
CPT CODE:
J$30.40J1325-6
CPT CODE:
J$30.40J1325-Q
CPT CODE:
J$19.61J1327-6
CPT CODE:
J$19.61J1327-Q
CPT CODE:
J$18.58J1330-Q
CPT CODE:
J$36.88J1335-6
CPT CODE:
J$36.88J1335-Q
CPT CODE:
J$20.54J1380-6
CPT CODE:
J$20.54J1380-Q
CPT CODE:
J$75.94J1410-6
CPT CODE:
J$75.94J1410-Q
CPT CODE:
J$190.62J1428-6
CPT CODE:
J$115.36J1430-6
CPT CODE:
J$115.36J1430-Q
CPT CODE:
J$20.54J1435-6
CPT CODE:
J$20.54J1435-Q
CPT CODE:
J$130.64J1436-6
CPT CODE:
J$130.64J1436-Q
CPT CODE:
J$228.85J1438-6
CPT CODE:
J$228.85J1438-Q
CPT CODE:
J$1.23J1439-6
CPT CODE:
J$1.22J1442-6
CPT CODE:
J$7.57J1443-6
CPT CODE:
J$1.77J1447-6
CPT CODE:
J$138.47J1450-6
CPT CODE:
J$138.47J1450-Q
CPT CODE:
J$19.07J1451-6
CPT CODE:
J$19.07J1451-Q
CPT CODE:
J$1,559.72J1452-6
CPT CODE:
J$1,559.72J1452-Q
CPT CODE:
J$2.46J1453-6
CPT CODE:
J$2.46J1453-Q
CPT CODE:
J$560.86J1454-6
CPT CODE:
J$20.54J1455-6
CPT CODE:
J$20.54J1455-Q
CPT CODE:
J$2.07J1457-6
CPT CODE:
J$2.07J1457-Q
CPT CODE:
J$488.95J1458-6
CPT CODE:
J$488.95J1458-Q
CPT CODE:
J$58.70J1459-6
CPT CODE:
J$58.70J1459-Q
CPT CODE:
J$20.54J1460-6
CPT CODE:
J$20.54J1460-Q
CPT CODE:
J$20.02J1555-6
CPT CODE:
J$75.01J1556-6
CPT CODE:
J$20.54J1560-6
CPT CODE:
J$20.54J1560-Q
CPT CODE:
J$59.87J1561-6
CPT CODE:
J$59.87J1561-Q
CPT CODE:
J$47.73J1566-6
CPT CODE:
J$47.73J1566-Q
CPT CODE:
J$72.80J1570-6
CPT CODE:
J$72.80J1570-Q
CPT CODE:
J$54.22J1575-6
CPT CODE:
J$20.54J1580-6
CPT CODE:
J$20.54J1580-Q
CPT CODE:
J$20.54J1600-6
CPT CODE:
J$20.54J1600-Q
CPT CODE:
J$28.76J1602-6
CPT CODE:
J$30.40J1626-6
CPT CODE:
J$30.40J1626-Q
CPT CODE:
J$5.90J1627-6
CPT CODE:
J$20.54J1630-6
CPT CODE:
J$20.54J1630-Q
CPT CODE:
J$67.17J1631-6
CPT CODE:
J$67.17J1631-Q
CPT CODE:
J$11.26J1640-6
CPT CODE:
J$11.26J1640-Q
CPT CODE:
J$13.08J1652-6
Page 66
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE:
J$13.08J1652-Q
CPT CODE:
J$6.49J1655-6
CPT CODE:
J$6.49J1655-Q
CPT CODE:
J$124.01J1670-6
CPT CODE:
J$124.01J1670-Q
CPT CODE:
J$20.54J1700-6
CPT CODE:
J$20.54J1700-Q
CPT CODE:
J$20.54J1710-6
CPT CODE:
J$20.54J1710-Q
CPT CODE:
J$20.54J1720-6
CPT CODE:
J$20.54J1720-Q
CPT CODE:
J$32.73J1726-6
CPT CODE:
J$15.33J1729-6
CPT CODE:
J$192.93J1740-6
CPT CODE:
J$192.93J1740-Q
CPT CODE:
J$1.64J1741-6
CPT CODE:
J$292.27J1742-6
CPT CODE:
J$292.27J1742-Q
CPT CODE:
J$98.86J1745-6
CPT CODE:
J$98.86J1745-Q
CPT CODE:
J$62.41J1746-6
CPT CODE:
J$1.03J1756-6
CPT CODE:
J$1.03J1756-Q
CPT CODE:
J$49.91J1786-6
CPT CODE:
J$49.91J1786-Q
CPT CODE:
J$20.54J1790-6
CPT CODE:
J$20.54J1790-Q
CPT CODE:
J$20.54J1800-6
CPT CODE:
J$20.54J1800-Q
CPT CODE:
J$20.54J1810-6
CPT CODE:
J$20.54J1810-Q
CPT CODE:
J$0.18J1815-6
CPT CODE:
J$0.18J1815-Q
CPT CODE:
J$1.82J1817-6
CPT CODE:
J$1.82J1817-Q
CPT CODE:
J$1,032.85J1826-6
CPT CODE:
J$1,032.85J1826-Q
CPT CODE:
J$293.58J1833-6
CPT CODE:
J$1,426.05J1835-6
CPT CODE:
J$1,426.05J1835-Q
CPT CODE:
J$20.54J1840-6
CPT CODE:
J$20.54J1840-Q
CPT CODE:
J$20.54J1850-6
CPT CODE:
J$20.54J1850-Q
CPT CODE:
J$20.54J1885-6
CPT CODE:
J$20.54J1885-Q
CPT CODE:
J$20.54J1890-6
CPT CODE:
J$20.54J1890-Q
CPT CODE:
J$33.65J1930-6
CPT CODE:
J$33.65J1930-Q
CPT CODE:
J$36.88J1931-6
CPT CODE:
J$36.88J1931-Q
CPT CODE:
J$20.54J1940-6
CPT CODE:
J$20.54J1940-Q
CPT CODE:
J$248.65J1945-6
CPT CODE:
J$248.65J1945-Q
CPT CODE:
J$0.80J1953-6
CPT CODE:
J$0.80J1953-Q
CPT CODE:
J$36.55J1956-6
CPT CODE:
J$36.55J1956-Q
CPT CODE:
J$20.54J1960-6
CPT CODE:
J$20.54J1960-Q
CPT CODE:
J$20.54J1980-6
CPT CODE:
J$20.54J1980-Q
CPT CODE:
J$20.54J1990-6
CPT CODE:
J$20.54J1990-Q
CPT CODE:
J$20.54J2010-6
CPT CODE:
J$20.54J2010-Q
CPT CODE:
J$58.78J2020-6
CPT CODE:
J$58.78J2020-Q
CPT CODE:
J$20.54J2060-6
CPT CODE:
J$20.54J2060-Q
CPT CODE:
J$16.50J2062-6
CPT CODE:
J$20.54J2150-6
CPT CODE:
J$20.54J2150-Q
CPT CODE:
J$20.54J2175-6
CPT CODE:
J$20.54J2175-Q
CPT CODE:
J$20.54J2180-6
CPT CODE:
J$20.54J2180-Q
CPT CODE:
J$30.76J2182-6
CPT CODE:
J$8.10J2185-6
CPT CODE:
J$8.10J2185-Q
CPT CODE:
J$18.15J2186-6
CPT CODE:
J$20.54J2210-6
CPT CODE:
J$20.54J2210-Q
CPT CODE:
J$0.48J2212-6
CPT CODE:
J$2.68J2248-6
CPT CODE:
J$2.68J2248-Q
CPT CODE:
J$20.54J2270-6
CPT CODE:
J$20.54J2270-Q
CPT CODE:
J$9.81J2274-6
CPT CODE:
J$9.62J2278-6
CPT CODE:
J$9.62J2278-Q
CPT CODE:
J$16.14J2280-6
CPT CODE:
J$16.14J2280-Q
CPT CODE:
J$20.54J2320-6
CPT CODE:
J$20.54J2320-Q
CPT CODE:
J$48.66J2325-6
CPT CODE:
J$48.66J2325-Q
CPT CODE:
J$1,241.00J2326-6
CPT CODE:
J$60.88J2350-6
CPT CODE:
J$129.01J2353-6
CPT CODE:
J$129.01J2353-Q
CPT CODE:
J$7.07J2354-6
CPT CODE:
J$7.07J2354-Q
CPT CODE:
J$438.52J2355-6
CPT CODE:
J$438.52J2355-Q
CPT CODE:
J$22.52J2357-6
CPT CODE:
J$22.52J2357-Q
CPT CODE:
J$4.02J2358-6
CPT CODE:
J$4.02J2358-Q
CPT CODE:
J$20.54J2360-6
CPT CODE:
J$20.54J2360-Q
CPT CODE:
J$20.54J2370-6
CPT CODE:
J$20.54J2370-Q
CPT CODE:
J$46.30J2400-6
CPT CODE:
J$46.30J2400-Q
CPT CODE:
J$11.20J2405-6
CPT CODE:
J$11.20J2405-Q
CPT CODE:
J$3,569.79J2407-6
CPT CODE:
J$20.54J2410-6
CPT CODE:
J$20.54J2410-Q
CPT CODE:
J$18.94J2425-6
CPT CODE:
J$18.94J2425-Q
CPT CODE:
J$9.61J2426-6
CPT CODE:
J$9.61J2426-Q
CPT CODE:
J$20.54J2460-6
CPT CODE:
J$20.54J2460-Q
CPT CODE:
J$48.74J2469-6
CPT CODE:
J$48.74J2469-Q
CPT CODE:
J$7.95J2501-6
CPT CODE:
J$7.95J2501-Q
CPT CODE:
J$13,256.45J2502-6
CPT CODE:
J$1,480.31J2503-6
CPT CODE:
J$1,480.31J2503-Q
CPT CODE:
J$270.00J2504-6
CPT CODE:
J$270.00J2504-Q
CPT CODE:
J$4,353.07J2505-6
CPT CODE:
J$4,353.07J2505-Q
CPT CODE:
J$20.54J2510-6
CPT CODE:
J$20.54J2510-Q
CPT CODE:
J$21.90J2513-6
CPT CODE:
J$21.90J2513-Q
CPT CODE:
J$20.54J2515-6
CPT CODE:
J$20.54J2515-Q
CPT CODE:
J$20.54J2540-6
CPT CODE:
J$20.54J2540-Q
CPT CODE:
J$8.88J2543-6
CPT CODE:
J$8.88J2543-Q
CPT CODE:
J$1,169.41J2547-6
CPT CODE:
J$20.54J2550-6
CPT CODE:
J$20.54J2550-Q
Page 67
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE:
J$20.54J2560-6
CPT CODE:
J$20.54J2560-Q
CPT CODE:
J$358.81J2562-6
CPT CODE:
J$358.81J2562-Q
CPT CODE:
J$20.54J2590-6
CPT CODE:
J$20.54J2590-Q
CPT CODE:
J$20.54J2650-6
CPT CODE:
J$20.54J2650-Q
CPT CODE:
J$50.00J2680-6
CPT CODE:
J$50.00J2680-Q
CPT CODE:
J$20.54J2690-6
CPT CODE:
J$20.54J2690-Q
CPT CODE:
J$20.54J2700-6
CPT CODE:
J$20.54J2700-Q
CPT CODE:
J$20.54J2710-6
CPT CODE:
J$20.54J2710-Q
CPT CODE:
J$20.54J2720-6
CPT CODE:
J$20.54J2720-Q
CPT CODE:
J$65.32J2730-6
CPT CODE:
J$65.32J2730-Q
CPT CODE:
J$63.46J2760-6
CPT CODE:
J$63.46J2760-Q
CPT CODE:
J$20.54J2765-6
CPT CODE:
J$20.54J2765-Q
CPT CODE:
J$167.56J2770-6
CPT CODE:
J$167.56J2770-Q
CPT CODE:
J$2.50J2780-6
CPT CODE:
J$2.50J2780-Q
CPT CODE:
J$549.67J2783-6
CPT CODE:
J$549.67J2783-Q
CPT CODE:
J$73.59J2785-6
CPT CODE:
J$73.59J2785-Q
CPT CODE:
J$9.60J2786-6
CPT CODE:
J$3,134.22J2787-6
CPT CODE:
J$56.85J2788-6
CPT CODE:
J$56.85J2788-Q
CPT CODE:
J$130.64J2790-6
CPT CODE:
J$38.21J2792-6
CPT CODE:
J$38.21J2792-Q
CPT CODE:
J$7.82J2794-6
CPT CODE:
J$7.82J2794-C
CPT CODE:
J$7.82J2794-Q
CPT CODE:
J$7.82J2794-X
CPT CODE:
J$1.57J2795-6
CPT CODE:
J$1.57J2795-Q
CPT CODE:
J$58.01J2796-6
CPT CODE:
J$58.01J2796-Q
CPT CODE:
J$0.98J2797-6
CPT CODE:
J$20.54J2800-6
CPT CODE:
J$20.54J2800-Q
CPT CODE:
J$218.38J2820-Q
CPT CODE:
J$574.32J2840-6
CPT CODE:
J$102.55J2860-6
CPT CODE:
J$20.54J2910-6
CPT CODE:
J$20.54J2910-Q
CPT CODE:
J$12.93J2916-6
CPT CODE:
J$12.93J2916-Q
CPT CODE:
J$20.54J2920-6
CPT CODE:
J$20.54J2920-Q
CPT CODE:
J$20.54J2930-6
CPT CODE:
J$20.54J2930-Q
CPT CODE:
J$68.04J2940-6
CPT CODE:
J$68.04J2940-Q
CPT CODE:
J$68.04J2941-6
CPT CODE:
J$68.04J2941-Q
CPT CODE:
J$20.54J2950-6
CPT CODE:
J$20.54J2950-Q
CPT CODE:
J$2,144.63J2993-6
CPT CODE:
J$42.87J2997-6
CPT CODE:
J$42.87J2997-Q
CPT CODE:
J$20.54J3000-6
CPT CODE:
J$20.54J3000-Q
CPT CODE:
J$20.54J3010-6
CPT CODE:
J$20.54J3010-Q
CPT CODE:
J$37.28J3060-6
CPT CODE:
J$20.54J3070-6
CPT CODE:
J$20.54J3070-Q
CPT CODE:
J$1.45J3090-6
CPT CODE:
J$3.14J3095-6
CPT CODE:
J$3.14J3095-Q
CPT CODE:
J$77.72J3101-6
CPT CODE:
J$77.72J3101-Q
CPT CODE:
J$20.54J3105-6
CPT CODE:
J$20.54J3105-Q
CPT CODE:
J$0.06J3121-6
CPT CODE:
J$1.38J3145-6
CPT CODE:
J$20.54J3230-6
CPT CODE:
J$20.54J3230-Q
CPT CODE:
J$363.97J3240-6
CPT CODE:
J$363.97J3240-Q
CPT CODE:
J$1.52J3243-6
CPT CODE:
J$1.52J3243-Q
CPT CODE:
J$145.78J3245-6
CPT CODE:
J$14.21J3246-6
CPT CODE:
J$14.21J3246-Q
CPT CODE:
J$20.54J3250-6
CPT CODE:
J$20.54J3250-Q
CPT CODE:
J$20.54J3260-6
CPT CODE:
J$20.54J3260-Q
CPT CODE:
J$4.28J3262-6
CPT CODE:
J$4.28J3262-Q
CPT CODE:
J$20.54J3280-6
CPT CODE:
J$20.54J3280-Q
CPT CODE:
J$89.54J3285-6
CPT CODE:
J$5.01J3300-6
CPT CODE:
J$5.01J3300-Q
CPT CODE:
J$20.54J3301-6
CPT CODE:
J$20.54J3301-Q
CPT CODE:
J$20.54J3302-6
CPT CODE:
J$20.54J3302-Q
CPT CODE:
J$20.54J3303-6
CPT CODE:
J$20.54J3303-Q
CPT CODE:
J$19.59J3304-6
CPT CODE:
J$20.54J3310-6
CPT CODE:
J$20.54J3310-Q
CPT CODE:
J$624.38J3315-6
CPT CODE:
J$624.38J3315-Q
CPT CODE:
J$3,005.91J3316-6
CPT CODE:
J$44.45J3320-6
CPT CODE:
J$44.45J3320-Q
CPT CODE:
J$139.99J3350-6
CPT CODE:
J$139.99J3350-Q
CPT CODE:
J$145.07J3357-6
CPT CODE:
J$145.07J3357-Q
CPT CODE:
J$13.83J3358-6
CPT CODE:
J$20.54J3360-6
CPT CODE:
J$20.54J3360-Q
CPT CODE:
J$109.28J3364-6
CPT CODE:
J$109.28J3364-Q
CPT CODE:
J$52.25J3370-6
CPT CODE:
J$52.25J3370-Q
CPT CODE:
J$19.77J3380-6
CPT CODE:
J$424.86J3385-6
CPT CODE:
J$424.86J3385-Q
CPT CODE:
J$14.52J3396-6
CPT CODE:
J$14.52J3396-Q
CPT CODE:
J$46.52J3397-6
CPT CODE:
J$20.54J3400-6
CPT CODE:
J$20.54J3400-Q
CPT CODE:
J$20.54J3410-6
CPT CODE:
J$20.54J3410-Q
CPT CODE:
J$1.47J3411-6
CPT CODE:
J$1.47J3411-Q
CPT CODE:
J$1.47J3415-6
CPT CODE:
J$1.47J3415-Q
CPT CODE:
J$20.54J3420-6
CPT CODE:
J$20.54J3420-Q
CPT CODE:
J$20.54J3430-6
CPT CODE:
J$20.54J3430-Q
CPT CODE:
J$7.75J3465-6
CPT CODE:
J$7.75J3465-Q
CPT CODE:
J$20.54J3470-6
Page 68
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE:
J$20.54J3470-Q
CPT CODE:
J$0.19J3471-6
CPT CODE:
J$0.19J3471-Q
CPT CODE:
J$223.85J3472-6
CPT CODE:
J$223.85J3472-Q
CPT CODE:
J$0.64J3473-6
CPT CODE:
J$0.64J3473-Q
CPT CODE:
J$1.57J3485-6
CPT CODE:
J$1.57J3485-Q
CPT CODE:
J$32.30J3486-6
CPT CODE:
J$32.30J3486-Q
CPT CODE:
J$262.31J3489-6
CPT CODE:
J$2.41J7121-6
CPT CODE:
J$54.55J7170-6
CPT CODE:
J$1.21J7177-6
CPT CODE:
J$1.14J7178-6
CPT CODE:
J$6.35J7188-6
CPT CODE:
J$2.13J7189-6
CPT CODE:
J$2.13J7189-Q
CPT CODE:
J$4.40J7203-6
CPT CODE:
J$2.23J7205-6
CPT CODE:
J$964.69J7296-6
CPT CODE:
J$765.57J7297-6
CPT CODE:
J$997.70J7298-6
CPT CODE:
J$813.17J7301-6
CPT CODE:
J$163.93J7308-6
CPT CODE:
J$163.93J7308-Q
CPT CODE:
J$103.89J7309-6
CPT CODE:
J$103.89J7309-Q
CPT CODE:
J$238.49J7312-6
CPT CODE:
J$238.49J7312-Q
CPT CODE:
J$570.13J7313-6
CPT CODE:
J$449.42J7315-6
CPT CODE:
J$1,234.79J7316-6
CPT CODE:
J$17.87J7318-6
CPT CODE:
J$8.04J7320-6
CPT CODE:
J$159.43J7321-6
CPT CODE:
J$19.15J7322-6
CPT CODE:
J$168.34J7323-6
CPT CODE:
J$287.38J7324-6
CPT CODE:
J$20.60J7325-6
CPT CODE:
J$1,130.45J7327-6
CPT CODE:
J$7.47J7329-6
CPT CODE:
J$3.28J7336-6
CPT CODE:
J$15.17J7345-6
CPT CODE:
J$527.94J7511-6
CPT CODE:
J$527.94J7511-Q
CPT CODE:
J$765.77J7513-6
CPT CODE:
J$378.72J7513-Q
CPT CODE:
J$53.38J7516-6
CPT CODE:
J$53.38J7516-Q
CPT CODE:
J$102.66J9000-Q
CPT CODE:
J$806.37J9010-Q
CPT CODE:
J$410.63J9019-6
CPT CODE:
J$104.54J9020-Q
CPT CODE:
J$85.57J9022-6
CPT CODE:
J$84.52J9023-6
CPT CODE:
J$5.67J9025-Q
CPT CODE:
J$162.73J9027-Q
CPT CODE:
J$37.10J9032-6
CPT CODE:
J$24.74J9033-Q
CPT CODE:
J$28.32J9034-Q
CPT CODE:
J$93.57J9035-Q
CPT CODE:
J$111.79J9039-6
CPT CODE:
J$546.89J9040-Q
CPT CODE:
J$44.58J9041-Q
CPT CODE:
J$121.58J9042-6
CPT CODE:
J$50.37J9044-6
CPT CODE:
J$181.49J9045-Q
CPT CODE:
J$34.55J9047-6
CPT CODE:
J$158.66J9050-Q
CPT CODE:
J$78.39J9055-Q
CPT CODE:
J$83.83J9057-6
CPT CODE:
J$75.94J9060-Q
CPT CODE:
J$11.20J9070-Q
CPT CODE:
J$592.42J9098-Q
CPT CODE:
J$14.93J9100-Q
CPT CODE:
J$24.26J9120-Q
CPT CODE:
J$28.00J9130-Q
CPT CODE:
J$54.79J9145-Q
CPT CODE:
J$151.21J9150-Q
CPT CODE:
J$114.63J9151-Q
CPT CODE:
J$199.52J9153-6
CPT CODE:
J$4.90J9155-Q
CPT CODE:
J$1,559.52J9160-Q
CPT CODE:
J$26.13J9165-Q
CPT CODE:
J$24.60J9171-Q
CPT CODE:
J$77.09J9173-6
CPT CODE:
J$5.18J9175-6
CPT CODE:
J$5.18J9175-Q
CPT CODE:
J$7.21J9176-Q
CPT CODE:
J$42.00J9178-Q
CPT CODE:
J$29.84J9181-Q
CPT CODE:
J$349.05J9185-Q
CPT CODE:
J$5.62J9190-Q
CPT CODE:
J$81.70J9199-6
CPT CODE:
J$242.64J9200-Q
CPT CODE:
J$148.67J9201-Q
CPT CODE:
J$837.16J9202-Q
CPT CODE:
J$204.80J9203-6
CPT CODE:
J$45.86J9205-Q
CPT CODE:
J$190.91J9206-Q
CPT CODE:
J$82.46J9207-Q
CPT CODE:
J$244.46J9208-Q
CPT CODE:
J$64.82J9209-Q
CPT CODE:
J$464.76J9211-Q
CPT CODE:
J$8.32J9212-Q
CPT CODE:
J$59.71J9213-Q
CPT CODE:
J$20.54J9214-Q
CPT CODE:
J$16.67J9215-Q
CPT CODE:
J$287.43J9216-Q
CPT CODE:
J$953.77J9217-Q
CPT CODE:
J$46.30J9218-Q
CPT CODE:
J$6,942.79J9225-Q
CPT CODE:
J$2,284.98J9229-6
CPT CODE:
J$22.38J9230-Q
CPT CODE:
J$18.67J9250-Q
CPT CODE:
J$31.72J9260-Q
CPT CODE:
J$2.99J9262-6
CPT CODE:
J$13.94J9263-Q
CPT CODE:
J$12.44J9264-Q
CPT CODE:
J$0.18J9267-6
CPT CODE:
J$2,956.42J9268-Q
CPT CODE:
J$154.93J9270-Q
CPT CODE:
J$53.12J9271-6
CPT CODE:
J$255.71J9280-Q
CPT CODE:
J$56.23J9285-6
CPT CODE:
J$1,265.44J9293-Q
CPT CODE:
J$6.09J9295-6
CPT CODE:
J$29.52J9299-6
CPT CODE:
J$62.99J9301-6
CPT CODE:
J$60.06J9302-Q
CPT CODE:
J$66.34J9305-Q
CPT CODE:
J$12.14J9306-6
CPT CODE:
J$213.29J9307-Q
CPT CODE:
J$62.78J9308-6
CPT CODE:
J$115.18J9309-6
CPT CODE:
J$51.66J9311-6
CPT CODE:
J$103.32J9312-6
CPT CODE:
J$288.17J9315-Q
CPT CODE:
J$140.75J9320-Q
CPT CODE:
J$53.69J9325-Q
CPT CODE:
J$6.12J9328-Q
CPT CODE:
J$61.87J9330-Q
CPT CODE:
J$172.25J9340-Q
CPT CODE:
J$35.51J9351-Q
CPT CODE:
J$328.74J9352-6
CPT CODE:
J$34.68J9354-6
CPT CODE:
J$79.00J9355-Q
CPT CODE:
J$684.54J9357-Q
CPT CODE:
J$31.72J9360-Q
CPT CODE:
J$67.17J9370-Q
Page 69
2020 Alabama Workers' Compensation Prevailing Rate/Maximum Fee Schedule for Physicians effective March 1, 2020
CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEE CPT CODE MAX FEECPT CODE:
J$2,438.32J9371-6
CPT CODE:
J$132.38J9395-Q
CPT CODE:
J$18.50J9400-6
CPT CODE:
J$4,348.35J9600-Q
CPT CODE: $89.48P9045-6
CPT CODE: $89.48P9045-Q
CPT CODE: $40.31P9046-6
CPT CODE: $40.31P9046-Q
CPT CODE: $120.72P9047-6
CPT CODE: $120.72P9047-Q
CPT CODE: $134.98P9048-6
CPT CODE: $134.98P9048-Q
CPT CODE: $13.29P9612-6
CPT CODE: $9.88P9615-6
CPT CODE: $1.08Q0138-6
CPT CODE: $1.08Q0138-Q
CPT CODE: $1.08Q0139-6
CPT CODE: $1.08Q0139-Q
CPT CODE: $59.03Q3031-6
CPT CODE: $1.71Q4081-6
CPT CODE: $1.71Q4081-Q
CPT CODE: $1.13Q5101-6
CPT CODE: $0.53Q9965-5
CPT CODE: $0.53Q9965-G
CPT CODE: $0.62Q9966-5
CPT CODE: $0.62Q9966-G
CPT CODE: $0.63Q9967-5
CPT CODE: $0.63Q9967-G
CPT CODE: $985.92Q9984-6
CPT CODE: $15.67Q9985-6
CPT CODE: $33.45Q9986-6
CPT CODE: $14.14Q9989-6
CPT CODE: $11.10S0156-6
CPT CODE: $11.10S0156-Q
CPT CODE: $32.66S0164-6
CPT CODE: $32.66S0164-Q
CPT CODE: $7.64S0166-6
CPT CODE: $7.64S0166-Q
CPT CODE: $34.44S0265-6
CPT CODE: $45.22S0311-6
CPT CODE: $67.66S0390-6
CPT CODE: $4,758.01S2068-2
CPT CODE: $3,120.13S2079-2
CPT CODE: $68.77S2083-2
CPT CODE: $2,434.77S2095-2
CPT CODE: $1,504.27S2117-2
CPT CODE: $4,651.61S2118-2
CPT CODE: $295.13S2225-2
CPT CODE: $2,157.37S2325-2
CPT CODE: $59.03S3000-6
CPT CODE: $59.03S3000-A
CPT CODE: $59.03S3000-M
CPT CODE: $59.03S3000-N
CPT CODE: $5,696.45S3865-8
CPT CODE: $926.25S3866-8
CPT CODE: $0.20S5550-6
CPT CODE: $0.20S5550-Q
CPT CODE: $0.47S5551-6
CPT CODE: $0.47S5551Q
CPT CODE: $736.18S9025-6
CPT CODE: $2,269.01S9034-2
CPT CODE: $687.42S9055-6
Page 70