Medical Records - Medical Evidence Fee Schedule

Revised on: July 1, 2020

Medical Records

Effective, July 1, 2020, you must be enrolled in ProviderOne to claim reimbursement for these services. For more information please visit the Health Care Authority’s ProviderOne Enrollment Page.

For questions about submitting a claim please contact ProviderOne at 1-800-562-3022 or online

If you are a Medical Records Company and need to enroll in ProviderOne for billing purposes, please complete Health Care Authority’s simplified payment agreement. Medical Record Companies can find billing guidance on how to submit a claim here.

NOTE: Medical record claims with a date of service prior to July 1, 2020 should be sent to the requesting Community Services Office (CSO) or Home and Community Services (HCS) Office for processing.

Service Type ⃰

Reimbursement Fee

ProviderOne Service Code

Taxonomy and Diagnosis Codes

Medical Records (copies)

$0.30 per page – maximum of 150 pages

 

 

S9982

Use Taxonomy: 246YR1600X (Registered Record Administrator)

Use Diagnosis Code: R69

Medical Records (clerical fee)

 

$20.00 S9981

Use Taxonomy: 246YR1600X (Registered Record Administrator)

Use Diagnosis Code: R69

Medical Records (sales tax and/or postage*)

 

Actual cost of tax and/or postage* if applicable S9999

Use Taxonomy: 246YR1600X (Registered Record Administrator)

Use Diagnosis Code: R69

* The cost of postage is eligible for reimbursement only if the Department was unable to provide the vendor with a postage-paid business reply envelope.