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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

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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