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Category: Fee Schedule

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Fee Schedule/not precluded

Oleg’s Acupuncture, P.C. v Hereford Ins. Co., 2018 NY Slip Op 50095(U)(App. Term 2d Dept. 2018) “Defendant supported its cross motion with an affidavit by its certified

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Certified medical coder sufficient

Precious Acupuncture Care, P.C. v Hereford Ins. Co., 2018 NY Slip Op 50042(U)(App. Term 2d Dept. 2018) ” Plaintiff moved for summary judgment, and defendant cross-moved for summary

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CPM from the Civil Court

Advanced Recovery Equip. & Supplies, LLC v Maya Assur. Co., 2018 NY Slip Op 50022(U)(App. Term 2d Dept. 2018) The CPM story has been a terrific coup

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By report?

Bronx Acupuncture Therapy, P.C., as asignee of Mejia v Hereford Ins. Co., 2017 NY Slip Op 79291(U)(2d Dept. 2017) This came out on July, 2017.  The Court

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CPT Code 97039 again

Acuhealth Acupuncture, P.C. v Hereford Ins. Co., 2017 NY Slip Op 51871(U)(App. Term 2d Dept. 2017) “As limited by its brief, plaintiff appeals from so much of

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Fee schedule defense failed

Laga v GEICO Ins. Co., 2017 NY Slip Op 51713(U)(App. Term 2d Dept. 2017) “Defendant failed to demonstrate that it had used the correct conversion factor in

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By-Report

Bronx Acupuncture Therapy, P.C. v Hereford Ins. Co., 2017 NY Slip Op 51452(U)(App. Term 2d Dept. 2017) “It is undisputed that defendant denied plaintiff’s claim for services

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A new 68.6 is coming next year

Rationality has finally reached us with the crazy New Jersey situation.   This will be published tomorrow and will be effect 1/8/18. Over billing beware. This

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Repriced CPT Code 64550

Compas Med., P.C. v 21st Century Ins. Co., 2017 NY Slip Op 51228(U)(App. Term 2d Dept. 2017) “Contrary to plaintiff’s further argument, defendant’s proof was sufficient to

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CPT Code 970309

Acupuncture Approach, P.C. v Tri State Consumer Ins. Co., 2017 NY Slip Op 51170(U)(App. Term 1st Dept. 2017) The long-failed out of scope defense, well has long-failed.

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