ADDITIONAL SPECIAL NOTE

The Kansas Workers Compensation Law specifically dictates that an injured employee shall not be liable for any charges above the amount contained within this fee schedule. The respective section of the Kansas Workers Compensation Law (K.S.A. 44-510j(h)) that prohibits an injured employee for being liable for any charges above the amount contained within this fee schedule reads as follows:

Any health care provider, nurse, physical therapist, any entity providing medical, physical or vocational rehabilitation services or providing reeducation or training pursuant to K.S.A. 44-510g and amendments thereto, medical supply establishment, surgical supply establishment, ambulance service or hospital which accept the terms of the workers compensation act by providing services or material thereunder shall be bound by the fees approved by the director and no injured employee or dependent of a deceased employee shall be liable for any charges above the amounts approved by the director.

Interpreter Services:

 If the services of an interpreter are required for the provision of medical care to a hearing impaired, speech impaired, or other person whose primary language is other than English, the following will apply: 

 Maximum allowable payment for the first hour or less is limited to $35.00. 

 Each additional quarter hour increment of time is to be paid at $8.75 per quarter hour increment. 

 Any reimbursement for necessary travel mileage (including any tolls and parking fees actually incurred) is to be at the rate prescribed for compensation of state officers and employees pursuant to K.S.A. 75- 3203a. 

Interpreter Services

Interpretative services may be covered, whether done orally or through sign language. Interpreters must provide only interpretation services for the agency. The services must facilitate access to Medicaid covered services.

In order for interpretation services to be covered by Iowa Medicaid, the services must meet the following criteria: 

♦ Provided by interpreters who provide only interpretive services 

♦ Interpreters may be employed or contracted by the billing provider

♦ The interpretive services must facilitate access to Medicaid covered services

Providers may only bill for these services if offered in conjunction with an otherwise Medicaid covered service. Medical staff that are bilingual are not reimbursed for the interpretation but only for their medical services

a. Documentation of the Service

The billing provider must document in the member’s record the: 

♦ Interpreter’s name or company, 

♦ Date and time of the interpretation, 

♦ Service duration (time in and time out), and 

♦ Cost of providing the service.

b. Qualifications

It is the responsibility of the billing provider to determine the interpreter’s competency. Sign language interpreters should be licensed pursuant to 645 Iowa Administrative Code 361. Oral interpreters should be guided by the standards developed by the National Council on Interpreting in Health Care.

Following is the instruction for billing interpretive services when that service is provided by an outside commercial translation service:

 Bill code T1013

  • For telephonic interpretive services use modifier “UC” to indicate that the payment should be made at a per-minute unit.

 • The lack of the UC modifier will indicate that the charge is being made for the 15 minute face-to-face unit.

♦ Enter the number of minutes actually used for the provision of the service. The 15 minute unit should be rounded up if the service is provided for 8 minutes or more.

NOTE: Because the same code is being used but a conditional modifier may be necessary, any claim where the UC modifier is NOT used and the units exceed 24 will be paid at 24 units. 

Replacement of Hearing Aids

Prior authorization is required for replacement of a hearing aid less than four years old, except when the member is a child under 21 years of age.

Adults requiring replacement of a hearing aid should have audiological tests reviewed by the physician or audiologist if the last evaluation is more than two years old. Children under 18 years of age should have an audiological test reviewed by the physician or audiologist before replacement of a hearing aid if the last evaluation is more than six months old.

h. Routine Maintenance

Routine maintenance is payable once every twelve months after the initial six month-service period.

Procedure Code          Description 

92592                      Monaural aid 

92593                      Binaural aids

4. Interpreter Services

Interpretative services may be covered, whether done orally or through sign language. Interpreters must provide only interpretation services for the agency. The services must facilitate access to Medicaid covered services.

In order for interpretation services to be covered by Iowa Medicaid, the services must meet the following criteria:

♦ Provided by interpreters who provide only interpretive services 

♦ Interpreters may be employed or contracted by the billing provider 

♦ The interpretive services must facilitate access to Medicaid covered services 

Providers may only bill for these services if offered in conjunction with an otherwise Medicaid covered service. Medical staff that are bilingual are not reimbursed for the interpretation but only for their medical services.

a. Documentation of the Service

The billing provider must document in the member’s record the: 

♦ Interpreter’s name or company, 

♦ Date and time of the interpretation, 

♦ Service duration (time in and time out), and 

♦ Cost of providing the service.

b. Qualifications

It is the responsibility of the billing provider to determine the interpreter’s competency. Sign language interpreters should be licensed pursuant to 645 Iowa Administrative Code 361. Oral interpreters should be guided by the standards developed by the National Council on Interpreting in Health Care.

Following is the instruction for billing interpretive services when that service is provided by an outside commercial translation service:

♦ Bill code T1013

• For telephonic interpretive services use modifier “UC” to indicate that the payment should be made at a per-minute unit.

• The lack of the UC modifier will indicate that the charge is being made for the 15 minute face-to-face unit.

♦ Enter the number of minutes actually used for the provision of the service. The 15 minute unit should be rounded up if the service is provided for 8 minutes or more.

NOTE: Because the same code is being used but a conditional modifier may be necessary, any claim where the UC modifier is NOT used and the units exceed 24 will be paid at 24 units.