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2007 Medicare Part B Non-Facility Limiting Charge is Not a Fee Schedule, and Insurers Are Permitted to Use Rates Established by Participating Physicians Fee Schedule When Reimbursing Diagnostic Codes, Thus Certifying Conflict With the Third DCA

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Progressive Express Ins. Co. v. SimonMed Imaging a/a/o Hilleri Brown, 6th District, Case No. 6d23-1145. L.T. Case No. 2020-SC-043217-O, (48 Fla. L. Weekly D990a) – This suit involved a dispute regarding application of the 2007 Participating Physicians Fee Schedule. SimonMed Imaging had performed a cervical MRI on Hilleri Brown in relation to injuries she sustained in an August 12, 2015, motor vehicle accident….
By: Marshall Dennehey
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