Statutes, codes, and regulations
California Code Of Regulations
Title 8 - Industrial RelationsDivision 1 - Department of Industrial RelationsChapter 4.5 - Division of Workers' CompensationSubchapter 1 - Administrative Director-Administrative Rules
Article 5.5.0 - Rules for Medical Treatment Billing and Payment on or After October 15, 2011
Section 9792.5.1 - Medical Billing and Payment Guide; Electronic Medical Billing and Payment Companion Guide; Various Implementation Guides

Cal. Code Regs. tit. 8 § 9792.5.1

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Current through Register 2024 Notice Reg. No. 50, December 13, 2024
Section 9792.5.1 - Medical Billing and Payment Guide; Electronic Medical Billing and Payment Companion Guide; Various Implementation Guides
(a) The California Division of Workers' Compensation Medical Billing and Payment Guide, versions listed below, which set forth billing, payment and coding rules for paper and electronic medical treatment bill submissions, are incorporated by reference. They may be downloaded from the Division of Workers' Compensation through the Department of Industrial Relations' website at www.dir.ca.gov or may be obtained by writing to:

DIVISION OF WORKERS' COMPENSATION MEDICAL UNIT

ATTN: MEDICAL BILLING AND PAYMENT GUIDE

P.O. BOX 71010

OAKLAND, CA 94612

(1) California Division of Workers' Compensation Medical Billing and Payment Guide 2011, for bills submitted on or after October 15, 2011.
(2) California Division of Workers' Compensation Medical Billing and Payment Guide, Version 1.1, for bills submitted on or after January 1, 2013.
(3) California Division of Workers' Compensation Medical Billing and Payment Guide, Version 1.2.1, for bills submitted on or after February 12, 2014.
(4) California Division of Workers' Compensation Medical Billing and Payment Guide, Version 1.2.2, for bills submitted on or after October 1, 2015.
(b) The California Division of Workers' Compensation Electronic Medical Billing and Payment Companion Guide, versions listed below, which set forth billing, payment and coding rules and technical information for electronic medical treatment bill submissions, are incorporated by reference. They may be downloaded from the Division of Workers' Compensation website at www.dir.ca.gov or may be obtained by writing to:

DIVISION OF WORKERS' COMPENSATION MEDICAL UNIT

ATTN: MEDICAL BILLING AND PAYMENT COMPANION GUIDE

P.O. BOX 71010

OAKLAND, CA 94612

(1) California Division of Workers' Compensation Electronic Medical Billing and Payment Companion Guide, Version 1.0, dated 2012, for bills submitted on or after October 18, 2012.
(2) California Division of Workers' Compensation Electronic Medical Billing and Payment Companion Guide, Version 1.1, for bills submitted on or after January 1, 2013.
(3) California Division of Workers' Compensation Electronic Medical Billing and Payment Companion Guide, Version 1.2, for bills submitted on or after February 12, 2014.

Cal. Code Regs. Tit. 8, § 9792.5.1

1. New section filed 4-18-2011; operative 4-18-2011 pursuant to Government Code section 11343.4 (Register 2011, No. 16).
2. Amendment of subsections (a), (b) and (h) filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 1). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.
3. Amendment of subsections (a), (b) and (h) refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsections (a), (b) and (h) refiled 9-30-2013 as an emergency; operative 10-1-2013 (Register 2013, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-30-2013 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 9-30-2013 order, including amendment of section, transmitted to OAL 12-30-2013 and filed 2-12-2014; amendments effective 2-12-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 7).
6. Amendment of subsection (a)(3) filed 9-30-2014; operative 9-30-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 40).
7. New subsection (a)(4) filed 9-21-2015; operative 10-1-2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 39).

Note: Authority cited: Sections 133, 4603.4, 4603.5 and 5307.3, Labor Code. Reference: Sections 4600, 4603.2 and 4603.4, Labor Code.

1. New section filed 4-18-2011; operative 4-18-2011 pursuant to Government Code section 11343.4 (Register 2011, No. 16).
2. Amendment of subsections (a), (b) and (h) filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 1). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.
3. Amendment of subsections (a), (b) and (h) refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsections (a), (b) and (h) refiled 9-30-2013 as an emergency; operative 10-1-2013 (Register 2013, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-30-2013 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 9-30-2013 order, including amendment of section, transmitted to OAL 12-30-2013 and filed 2-12-2014; amendments effective 2-12-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 7).
6. Amendment of subsection (a)(3) filed 9-30-2014; operative 9/30/2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 40).
7. New subsection (a)(4) filed 9-21-2015; operative 10/1/2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 39).