§ 10.806 How are the maximum fees defined?
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Title 20 CFR: Employees' Benefits › Chapter I: OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR › Part 10: CLAIMS FOR COMPENSATION UNDER THE FEDERAL EMPLOYEES' COMPENSATION ACT, AS AMENDED › Subpart I: Information for Medical Providers › § 10.806: § 10.806 How are the maximum fees defined?
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For professional medical services, the Director shall maintain a schedule of maximum allowable fees for procedures performed in a given locality. The schedule shall consist of: An assignment of Relative Value Units (RVU) to procedures identified by Healthcare Common Procedure Coding System/Current Procedural Terminology (HCPCS/CPT) code which represents the relative skill, effort, risk and time required to perform the procedure, as compared to other procedures of the same general class; an assignment of Geographic Practice Cost Index (GPCI) values which represent the relative work, practice expenses and malpractice expenses relative to other localities throughout the country; and a monetary value assignment (conversion factor) for one unit of value for each coded service.
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