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Category: Fee Schedule

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Reasonableness of healthcare bill

Spanakos v Racanelli, 2021 NY Slip Op 50127(U)(App. Term 2d Dept. 2021) (1) “Plaintiff, a chiropractor, brought this action to recover, among other things, the balance

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CPT Code 97813 and 97814

Live In Grace Acupuncture, P.C. v GEICO Gen. Ins. Co., 2020 NY Slip Op 51360(U)(App. Term 2d Dept. 2020) “The branch of defendant’s cross motion seeking

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The chiropractor rate

S.O.V. Acupuncture, P.C. v Global Liberty Ins. Co. of N.Y., 2020 NY Slip Op 51004(U)(App. Term 2d Dept. 2020) Well in a few weeks and to

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120-day rule and Fee Schedule

Crystal Acupuncture, P.C. v Travelers Ins., 2019 NY Slip Op 52055(U)(App. Term 2d Dept. 2019) “With respect to the branches of defendant’s cross motion which sought

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Certified Professional Coder

“Contrary to plaintiff’s contention, the affidavit executed by defendant’s certified medical coder, submitted in support of defendant’s motion, established that, to the extent that plaintiff sought

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The By-Report

Bronx Acupuncture Therapy, P.C. v Hereford Ins. Co., 2019 NY Slip Op 06059 (2d Dept. 2019) The oral argument and facts of this case were uninspiring.

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The new fee schedule

New fee schedule I am just giving the highlights here. Regulatory impacted statement “The Superintendent therefore, deems it necessary to delay for 18 months the adoption

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The New Jersey ASC

At its simplest, when the codes is not in the ASC, there is no compensation for it. NEW JERSEY MANUFACTURERS INSURANCE COMPANY VS. SPECIALTY SURGICAL CENTER

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Down-coding acceptable

Urban Well Acupuncture, P.C. v Global Liberty Ins. Co. of N.Y., 2018 NY Slip Op 51833(U)(App. Term 1st Dept. 2018) “In opposition to defendant-insurer’s prima facie showing

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The By Report paradigm

Pavlova v Allstate Ins. Co., 2018 NY Slip Op 51654(U)(App. Term 2d Dept. 2018) “Plaintiff properly argues that where, as here, a provider does not provide such

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A 65-3.2 sighting

Village Med. Supply, Inc. v Travelers Prop. Cas. Ins. Co., 2018 NY Slip Op 51311(U)(App. Term 1sr Dept, 2018) “Defendant-insurer established its prima facie entitlement to summary

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